Journal of Gastroenterology

, Volume 49, Issue 5, pp 907–916 | Cite as

Autophagy enhances hepatocellular carcinoma progression by activation of mitochondrial β-oxidation

  • Takeo Toshima
  • Ken Shirabe
  • Yoshihiro Matsumoto
  • Shohei Yoshiya
  • Toru Ikegami
  • Tomoharu Yoshizumi
  • Yuji Soejima
  • Tetsuo Ikeda
  • Yoshihiko Maehara
Original Article—Liver, Pancreas, and Biliary Tract



Several types of cancers, including hepatocellular carcinoma (HCC), show resistance to hypoxia and nutrient starvation. Autophagy is a means of providing macromolecules for energy generation under such stressed-conditions. The aim of this study was to clarify the role of autophagy in HCC development under hypoxic conditions.


The expression of microtubule-associated protein 1 light chain 3 (LC3), which is a key gene involved in autophagosome formation, was evaluated in human HCC using immunohistochemistry and western blot. The relationship between LC3 and hypoxia-induced factor 1α (HIF1α) expression was examined using real-time PCR. In addition, human HCC cell line Huh7 was treated with pharmacological autophagy-inhibitor and inactive mutant of Atg4B (Atg4BC74A) under hypoxic condition to evaluate the effects of hypoxia-induced autophagy on cell survival, intracellular ATP, and mitochondrial β-oxidation.


LC3 was significantly highly expressed in HCC as compared with noncancerous tissues. LC3 expression, correlated with HIF1α expression, was also significantly correlated with tumor size, and only in the context of large tumors, was an independent predictor of HCC recurrence after surgery. In addition, Huh7 treated with autophagy-inhibitor under hypoxia had lower viability, with low levels of intracellular ATP due to impaired mitochondrial β-oxidation.


Autophagy in HCC works to promote HIF1α-mediated proliferation through the maintenance of intracellular ATP, depending on the activation of mitochondrial β-oxidation. These findings demonstrated the feasibility of anti-autophagic treatment as a potential curative therapy for HCC, and improved understanding of the factors determining adaptive metabolic responses to hypoxic conditions.


Autophagy Cancer progression Hepatocellular carcinoma 





Autophagy-related genes


Adenosine 5′-triphosphate


Des-gamma-carboxy prothrombin


Hepatocellular carcinoma


Hypoxia-induced factor 1α


Indocyanine green retention test at 15 min


Microtubule-associated protein 1 light chain 3


Phosphate-buffered saline


Polymerase chain reaction


Phosphatidylinositol 3-kinase


Reactive oxygen species


Standard deviation





We are grateful to T. Yoshimori (Osaka University) for kindly providing the inactive mutant of Atg4B (Atg4BC74A). We also thank N. Yamashita (Kyushu University) for her expert advice related to statistical analysis.

Conflict of interest

The authors have no conflicts of interest to declare and have no financial interests linked to this work.

Supplementary material

535_2013_835_MOESM1_ESM.tif (1.5 mb)
Supplementary material 1 (TIFF 1520 kb)
535_2013_835_MOESM2_ESM.doc (88 kb)
Supplementary material 2 (DOC 88 kb)


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Takeo Toshima
    • 1
  • Ken Shirabe
    • 1
  • Yoshihiro Matsumoto
    • 1
  • Shohei Yoshiya
    • 1
  • Toru Ikegami
    • 1
  • Tomoharu Yoshizumi
    • 1
  • Yuji Soejima
    • 1
  • Tetsuo Ikeda
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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