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Ding et al. Hepatoma Res 2018;4:12  I  http://dx.doi.org/10.20517/2394-5079.2018.07                                                  Page 5 of 8


                                                            d
                          0.5
                                           b                                                 TNF-α
                                                                      e
                                                                                             IL-1β
                          0.4
                                                   c
                                                                                             AFP
                                 a
                          0.3


                          0.2


                          0.1


                          0.0
                                  A                 B                 C                  D                 E                  F
                                                        Groups

               Figure 3. Expression of TNF-α, IL-1β and AFP by ELISA in six groups. Group A: non-transfected, non-treated cells; group B: transient
               β2GPI-and HBsAg-transfection without LPS treatment; group C: non-transfected cells treated with 100 ng/mL LPS; group D: transient
               β2GPI- and HBsAg-transfection and treated with 100 ng/mL LPS; group E: transient β2GPI-transfection and treated with 100 ng/mL
               LPS; group F: transient HBsAg-transfection and treated with 100 ng/mL LPS. Data presented as means ± SD. a: groups B, C, D, E, and F
               compared with group A, P < 0.05; b: group B compared with groups A, C, E, and F, P < 0.05; c: groups E and F compared with group C, P <
               0.05; d: group D compared with groups A, B, C, E, and F, P < 0.00; e: group E compared with group F, P > 0.05; f: group C compared with
               groups B, E, and F, P < 0.05. β2GPI: beta2-glycoprotein I; HBsAg: hepatitis B surface antigen; LPS: lipopolysaccharide

               C (590.4 ± 9.49) (P < 0.05). The level of NF-κB activation in group E and F were similar (P > 0.05). Taken
               together, these data suggest that LPS alone induced activation of NF-κB, which enhanced by either β2GPI- or
               HBsAg-transfection. However, the highest effect was seen in doubly-transfected cells, suggesting synergism
               between LPS, β2GPI and HBsAg with respect to activation of NF-κB in HCC.


               LPS induced increased expression of TNF-α, IL-1β, and AFP in β2GPI- and/or HBsAg-
               transfected cells
               Cell supernatants from the six groups were collected and levels of TNF-α, IL-1β and AFP were assayed

               24 h after transfection of respective recombinant plasmids. As depicted in Figure 3, groups B, C, D, E, and
               F induced expression of TNF-α, IL-1β and AFP more than did group A (P < 0.05). The highest expression
               levels of all three cytokines was seen in group D (doubly transfected with β2GPI and HBsAg and treated with
               LPS) (P < 0.001). The expression levels of IL-1β and AFP in group B was higher (P < 0.05) were higher than
               those of groups A, C, E, and F, while their expression in groups E and F were higher than those of group C
               (P < 0.05). The expression of TNF-α in group C was higher than that of groups B, E, and F (P < 0.05). TNF-α
               and IL-1β levels were similar in groups E and F (P > 0.05), while AFP in these groups were significantly
               higher than in group A (P < 0.05).



               DISCUSSION
               HCC, one of the most common tumors, is currently the fifth most common malignant tumor worldwide,
               with morbidity increasing every year. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes
                      [10]
               of HCC . Therapeutic options include etiological treatment, resection, percutaneous ablation, trans-arterial
               chemoembolization (TACE), and targeted therapy. The overall efficacy of these therapies is poor, and five-
                                                                    [11]
               year survival rates for early treatment of HCC are not favorable . Therefore, understanding the pathogenesis
               of HCC (abnormal neovascularization, genomics, proteomics and signal transduction pathways) is necessary
               to understand how HCC occurs and to develop new therapeutic approaches.
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