1   512 137 ASSOCIATION OF SAT-A AND ALU METHYLATION STATUS WITH HCV-INDUCED CHRONIC LIVER DISEASE AND HEPATOCELLULAR CARCINOMA. BACKGROUND: THE COMBINATION OF EPIGENETIC AND GENETIC ABNORMALITIES CONTRIBUTES TOGETHER TO THE DEVELOPMENT OF LIVER CANCER. THE METHYLATION STATUS OF THE REPETITIVE ELEMENTS (RES) IN DNA HAS BEEN INVESTIGATED IN A VARIETY OF HUMAN ILLNESSES. HOWEVER, THE METHYLATION PATTERNS OF SAT-ALPHA AND ALU RES IN CHRONIC LIVER DISEASE (CLD) AND HEPATOCELLULAR CARCINOMA (HCC) CAUSED BY HEPATITIS C VIRUS (HCV) HAVE NEVER BEEN STUDIED BEFORE. METHODOLOGY: IN THIS STUDY, 3 GROUPS OF PARTICIPANTS INCLUDING 50 PATIENTS HAVING HCV-INDUCED CLD, 50 PATIENTS HAVING HCV-INDUCED HCC, AND 46 HEALTHY SUBJECTS WERE SUBJECTED TO MEASUREMENT OF SAT-ALPHA AND ALU METHYLATION USING THE QUANTITATIVE METHYLIGHT ASSAY. RESULTS: SAT-ALPHA AND ALU METHYLATION PERCENTAGES DECREASED SIGNIFICANTLY IN BOTH CLD AND HCC, COMPARED TO CONTROL. ALSO, A SIGNIFICANT SAT-ALPHA HYPOMETHYLATION WAS DETECTED IN HCC, COMPARED TO CLD. IN ADDITION, SAT-ALPHA AND ALU METHYLATION SHOWED A SIGNIFICANT DECLINE AS LESION SIZE GREW. HOWEVER, ONLY SAT-ALPHA HYPOMETHYLATION WAS SIGNIFICANTLY INCREASED IN ASSOCIATION WITH PORTAL VEIN THROMBOSIS AND THE MELD SCORE. SAT-ALPHA METHYLATION PERCENTAGE HAD THE HIGHEST SENSITIVITY AND SPECIFICITY FOR DIAGNOSING HCC (100% AND 84.4%) FOLLOWED BY ALPHA-FETOPROTEIN (80% AND 84.4%) AND ALU METHYLATION (66% AND 61.5%). FURTHERMORE, THERE WAS A STRONG POSITIVE CORRELATION BETWEEN SAT-ALPHA AND ALU METHYLATION. CONCLUSIONS: MEASURING SAT-ALPHA AND ALU METHYLATION PROVIDES US WITH A NEW TOOL FOR EARLY DETECTING HCV-INDUCED CLD AND HEPATOCARCINOGENESIS. SAT-ALPHA HAS THE POTENTIAL TO BE UTILIZED AS AN INDEPENDENT PREDICTIVE PARAMETER FOR HCC DEVELOPMENT AND PROGRESSION BECAUSE OF ITS ABILITY TO DISTINGUISH BETWEEN CLD AND HCC WITH THEIR DIFFERENT MELD SCORES.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
2  2258  35 EPIGENETIC PRIMING IN CHRONIC LIVER DISEASE IMPACTS THE TRANSCRIPTIONAL AND GENETIC LANDSCAPES OF HEPATOCELLULAR CARCINOMA. HEPATOCELLULAR CARCINOMAS (HCCS) USUALLY ARISE FROM CHRONIC LIVER DISEASE (CLD). PRECANCEROUS CELLS IN CHRONICALLY INFLAMED ENVIRONMENTS MAY BE 'EPIGENETICALLY PRIMED', SENSITISING THEM TO ONCOGENIC TRANSFORMATION. WE INVESTIGATED WHETHER EPIGENETIC PRIMING IN CLD MAY AFFECT HCC OUTCOMES BY INFLUENCING THE GENOMIC AND TRANSCRIPTOMIC LANDSCAPES OF HCC. ANALYSIS OF DNA METHYLATION ARRAYS FROM 10 PAIRED CLD-HCC IDENTIFIED 339 SHARED DYSREGULATED CPG SITES AND 18 SHARED DIFFERENTIALLY METHYLATED REGIONS COMPARED WITH HEALTHY LIVERS. THESE REGIONS WERE ASSOCIATED WITH DYSREGULATED EXPRESSION OF GENES WITH RELEVANCE IN HCC, INCLUDING UBIQUITIN D (UBD), CYTOCHROME P450 FAMILY 2 SUBFAMILY C MEMBER 19 (CYP2C19) AND O-6-METHYLGUANINE-DNA METHYLTRANSFERASE (MGMT). METHYLATION CHANGES WERE RECAPITULATED IN AN INDEPENDENT COHORT OF NINE PAIRED CLD-HCC. HIGH CLD METHYLATION SCORE, DEFINED USING THE 124 DYSREGULATED CPGS IN CLD AND HCC IN BOTH COHORTS, WAS ASSOCIATED WITH POOR SURVIVAL, INCREASED SOMATIC GENETIC ALTERATIONS AND TP53 MUTATIONS IN TWO INDEPENDENT HCC COHORTS. ONCOGENIC TRANSCRIPTIONAL AND METHYLATION DYSREGULATION IS EVIDENT IN CLD AND COMPOUNDED IN HCC. EPIGENETIC PRIMING IN CLD SCULPTS THE TRANSCRIPTIONAL LANDSCAPE OF HCC AND CREATES AN ENVIRONMENT FAVOURING THE ACQUISITION OF GENETIC ALTERATIONS, SUGGESTING THAT THE EXTENT OF EPIGENETIC PRIMING IN CLD COULD INFLUENCE DISEASE OUTCOME.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
3  6208  52 THE INTERACTION BETWEEN MICRORNA-152 AND DNA METHYLTRANSFERASE-1 AS AN EPIGENETIC PROGNOSTIC BIOMARKER IN HCV-INDUCED LIVER CIRRHOSIS AND HCC PATIENTS. THE NECESSITY FOR EARLY DETECTION AND HENCE IMPROVING THE OUTCOME OF TREATMENT OF HEPATOCELLULAR CARCINOMA (HCC) IS CRITICAL ESPECIALLY IN HEPATITIS C VIRUS (HCV)-GENOTYPE 4 INDUCED CASES. IN OUR CURRENT WORK, WE EXAMINED THE MIRNA-152 AND DNMT-1 EXPRESSION IN CHRONIC LIVER DISEASE (CLD) DUE TO HCV GENOTYPE 4 INFECTION WITH/WITHOUT CIRRHOSIS AND HCC PATIENTS AS AN ATTEMPT TO EVALUATE THE POTENTIAL BENEFITS OF THESE NEW CIRCULATING, NONINVASIVE, PROGNOSTIC, EPIGENETIC MARKERS FOR LIVER CIRRHOSIS AND CARCINOGENESIS OF EGYPTIAN PATIENTS. EIGHTY SUBJECTS WERE INCLUDED IN THIS STUDY, DIVIDED INTO TWO GROUPS; GROUP I (40 PATIENTS) WERE CLASSIFIED INTO SUBGROUP IA (CLD WITHOUT CIRRHOSIS, N = 18) AND SUBGROUP IB (CLD WITH CIRRHOSIS, N = 22), GROUP II (CLD PATIENTS WITH HCC, N = 20), AND CONTROL (HEALTHY VOLUNTEER, N = 20). THE EXPRESSION OF MIRNA-152 AND DNMT-1 GENES WERE ANALYZED USING REAL-TIME PCR. MIRNA-152 SHOWED A PERSISTENT AND SIGNIFICANT DOWNREGULATION IN ALL DISEASED GROUPS, WHICH WAS IN CONSISTENCE WITH THE PROGRESSION OF THE DISEASE TOWARD THE HCC STAGE. DNMT-1 SHOWED UPREGULATION IN ALL DISEASED GROUPS WHEN COMPARED TO CONTROL AND SUBGROUP IA. THE MIRNA-152 WAS SHOWN TO CORRELATE INVERSELY WITH DNMT-1 IN SUBGROUP IA, IB AND GROUP II (R = -0.557, P < 0.01), (R = -0.850, P < 0.001) AND (R = -0.544, P < 0.02) RESPECTIVELY. IN ADDITION, MIRNA-152 AND DNMT-1 SHOWED A DIAGNOSTIC ABILITY TO DISCRIMINATE BETWEEN CASES OF CIRRHOSIS AND HCC AGAINST CLD WITHOUT CIRRHOSIS (P < 0.01), WHILE DNMT-1 DID NOT, EXCEPT BETWEEN HCC AND CIRRHOTIC CASES. FURTHERMORE, BOTH GENES CAN BE CONSIDERED AS PREDICTOR AND PROGNOSTIC PARAMETERS FOR CIRRHOSIS (OR = 1.041, P = 0.043) AND (OR = 1.039, P = 0.04) RESPECTIVELY, WHILE MIRNA-152 ALONE IS PROVED AS A PROGNOSTIC MARKER FOR HCC (OR = 1.003, P = 0.044). FINALLY, THE PERSISTENT REVERSE CORRELATION BETWEEN MIRNA-152 WITH DNMT-1 PROMPTS THEIR USE AS NONINVASIVE PROGNOSTIC BIOMARKERS FOR HCV INDUCED LIVER CIRRHOSIS AND HCC IN HCV GENOTYPE 4 PATIENTS.	2020	
                                                                                                                                                                                                                                                                                                                                                                              
4  2545  26 EPIGENETICS IN LIVER FIBROSIS: COULD HDACS BE A THERAPEUTIC TARGET? CHRONIC LIVER DISEASES (CLD) REPRESENT A WORLDWIDE HEALTH PROBLEM. WHILE CLDS MAY HAVE DIVERSE ETIOLOGIES, A COMMON PATHOGENIC DENOMINATOR IS THE PRESENCE OF LIVER FIBROSIS. CIRRHOSIS, THE END-STAGE OF CLD, IS CHARACTERIZED BY EXTENSIVE FIBROSIS AND IS MARKEDLY ASSOCIATED WITH THE DEVELOPMENT OF HEPATOCELLULAR CARCINOMA. THE MOST IMPORTANT EVENT IN HEPATIC FIBROGENESIS IS THE ACTIVATION OF HEPATIC STELLATE CELLS (HSC) FOLLOWING LIVER INJURY. ACTIVATED HSCS ACQUIRE A MYOFIBROBLAST-LIKE PHENOTYPE BECOMING PROLIFERATIVE, FIBROGENIC, AND CONTRACTILE CELLS. WHILE TRANSIENT ACTIVATION OF HSCS IS PART OF THE PHYSIOLOGICAL MECHANISMS OF TISSUE REPAIR, PROTRACTED ACTIVATION OF A WOUND HEALING REACTION LEADS TO ORGAN FIBROSIS. THE PHENOTYPIC CHANGES OF ACTIVATED HSCS INVOLVE EPIGENETIC MECHANISMS MEDIATED BY NON-CODING RNAS (NCRNA) AS WELL AS BY CHANGES IN DNA METHYLATION AND HISTONE MODIFICATIONS. DURING CLD THESE EPIGENETIC MECHANISMS BECOME DEREGULATED, WITH ALTERATIONS IN THE EXPRESSION AND ACTIVITY OF EPIGENETIC MODULATORS. HERE WE PROVIDE AN OVERVIEW OF THE EPIGENETIC ALTERATIONS INVOLVED IN FIBROGENIC HSCS TRANSDIFFERENTIATION WITH PARTICULAR FOCUS ON HISTONES ACETYLATION CHANGES. WE ALSO DISCUSS RECENT STUDIES SUPPORTING THE PROMISING THERAPEUTIC POTENTIAL OF HISTONE DEACETYLASE INHIBITORS IN LIVER FIBROSIS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
5  4104  29 MECHANISM AND THERAPEUTIC OPPORTUNITIES OF HISTONE MODIFICATIONS IN CHRONIC LIVER DISEASE. CHRONIC LIVER DISEASE (CLD) REPRESENTS A GLOBAL HEALTH PROBLEM, ACCOUNTING FOR THE HEAVY BURDEN OF DISABILITY AND INCREASED HEALTH CARE UTILIZATION. EPIGENOME ALTERATIONS PLAY AN IMPORTANT ROLE IN THE OCCURRENCE AND PROGRESSION OF CLD. HISTONE MODIFICATIONS, WHICH INCLUDE ACETYLATION, METHYLATION, AND PHOSPHORYLATION, REPRESENT AN ESSENTIAL PART OF EPIGENETIC MODIFICATIONS THAT AFFECT THE TRANSCRIPTIONAL ACTIVITY OF GENES. DIFFERENT FROM GENETIC MUTATIONS, HISTONE MODIFICATIONS ARE PLASTIC AND REVERSIBLE. THEY CAN BE MODULATED PHARMACOLOGICALLY WITHOUT CHANGING THE DNA SEQUENCE. THUS, THERE MIGHT BE CHANCES TO ESTABLISH INTERVENTIONAL SOLUTIONS BY TARGETING HISTONE MODIFICATIONS TO REVERSE CLD. HERE WE SUMMARIZED THE ROLES OF HISTONE MODIFICATIONS IN THE CONTEXT OF ALCOHOLIC LIVER DISEASE (ALD), METABOLIC ASSOCIATED FATTY LIVER DISEASE (MAFLD), VIRAL HEPATITIS, AUTOIMMUNE LIVER DISEASE, DRUG-INDUCED LIVER INJURY (DILI), AND LIVER FIBROSIS OR CIRRHOSIS. THE POTENTIAL TARGETS OF HISTONE MODIFICATIONS FOR TRANSLATION INTO THERAPEUTICS WERE ALSO INVESTIGATED. IN PROSPECT, HIGH EFFICACY AND LOW TOXICITY DRUGS THAT ARE SELECTIVELY TARGETING HISTONE MODIFICATIONS ARE REQUIRED TO COMPLETELY REVERSE CLD AND PREVENT THE DEVELOPMENT OF LIVER CIRRHOSIS AND MALIGNANCY.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
6  4108  17 MECHANISMS AND DISEASE CONSEQUENCES OF NONALCOHOLIC FATTY LIVER DISEASE. NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) IS THE LEADING CHRONIC LIVER DISEASE WORLDWIDE. ITS MORE ADVANCED SUBTYPE, NONALCOHOLIC STEATOHEPATITIS (NASH), CONNOTES PROGRESSIVE LIVER INJURY THAT CAN LEAD TO CIRRHOSIS AND HEPATOCELLULAR CARCINOMA. HERE WE PROVIDE AN IN-DEPTH DISCUSSION OF THE UNDERLYING PATHOGENETIC MECHANISMS THAT LEAD TO PROGRESSIVE LIVER INJURY, INCLUDING THE METABOLIC ORIGINS OF NAFLD, THE EFFECT OF NAFLD ON HEPATIC GLUCOSE AND LIPID METABOLISM, BILE ACID TOXICITY, MACROPHAGE DYSFUNCTION, AND HEPATIC STELLATE CELL ACTIVATION, AND CONSIDER THE ROLE OF GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS THAT PROMOTE FIBROSIS PROGRESSION AND RISK OF HEPATOCELLULAR CARCINOMA IN NASH.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
7  4454  30 MOLECULAR MECHANISMS DRIVING PROGRESSION OF LIVER CIRRHOSIS TOWARDS HEPATOCELLULAR CARCINOMA IN CHRONIC HEPATITIS B AND C INFECTIONS: A REVIEW. ALMOST ALL PATIENTS WITH HEPATOCELLULAR CARCINOMA (HCC), A MAJOR TYPE OF PRIMARY LIVER CANCER, ALSO HAVE LIVER CIRRHOSIS, THE SEVERITY OF WHICH HAMPERS EFFECTIVE TREATMENT FOR HCC DESPITE RECENT PROGRESS IN THE EFFICACY OF ANTICANCER DRUGS FOR ADVANCED STAGES OF HCC. HERE, WE REVIEW RECENT KNOWLEDGE CONCERNING THE MOLECULAR MECHANISMS OF LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC FROM GENETIC AND EPIGENOMIC POINTS OF VIEW. BECAUSE ~70% OF PATIENTS WITH HCC HAVE HEPATITIS B VIRUS (HBV) AND/OR HEPATITIS C VIRUS (HCV) INFECTION, WE FOCUSED ON HBV- AND HCV-ASSOCIATED HCC. THE LITERATURE SUGGESTS THAT GENETIC AND EPIGENETIC FACTORS, SUCH AS MICRORNAS, PLAY A ROLE IN LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC, AND THAT HBV- AND HCV-ENCODED PROTEINS APPEAR TO BE INVOLVED IN HEPATOCARCINOGENESIS. FURTHER STUDIES ARE NEEDED TO ELUCIDATE THE MECHANISMS, INCLUDING IMMUNE CHECKPOINTS AND MOLECULAR TARGETS OF KINASE INHIBITORS, ASSOCIATED WITH LIVER CIRRHOSIS AND ITS PROGRESSION TO HCC.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
8   319  30 ALCOHOLIC LIVER DISEASE. ALCOHOLIC LIVER DISEASE (ALD) IS THE MOST PREVALENT TYPE OF CHRONIC LIVER DISEASE WORLDWIDE. ALD CAN PROGRESS FROM ALCOHOLIC FATTY LIVER (AFL) TO ALCOHOLIC STEATOHEPATITIS (ASH), WHICH IS CHARACTERIZED BY HEPATIC INFLAMMATION. CHRONIC ASH CAN EVENTUALLY LEAD TO FIBROSIS AND CIRRHOSIS AND IN SOME CASES HEPATOCELLULAR CANCER (HCC). IN ADDITION, SEVERE ASH (WITH OR WITHOUT CIRRHOSIS) CAN LEAD TO ALCOHOLIC HEPATITIS, WHICH IS AN ACUTE CLINICAL PRESENTATION OF ALD THAT IS ASSOCIATED WITH LIVER FAILURE AND HIGH MORTALITY. MOST INDIVIDUALS CONSUMING >40 G OF ALCOHOL PER DAY DEVELOP AFL; HOWEVER, ONLY A SUBSET OF INDIVIDUALS WILL DEVELOP MORE ADVANCED DISEASE. GENETIC, EPIGENETIC AND NON-GENETIC FACTORS MIGHT EXPLAIN THE CONSIDERABLE INTERINDIVIDUAL VARIATION IN ALD PHENOTYPE. THE PATHOGENESIS OF ALD INCLUDES HEPATIC STEATOSIS, OXIDATIVE STRESS, ACETALDEHYDE-MEDIATED TOXICITY AND CYTOKINE AND CHEMOKINE-INDUCED INFLAMMATION. DIAGNOSIS OF ALD INVOLVES ASSESSING PATIENTS FOR ALCOHOL USE DISORDER AND SIGNS OF ADVANCED LIVER DISEASE. THE DEGREE OF AFL AND LIVER FIBROSIS CAN BE DETERMINED BY ULTRASONOGRAPHY, TRANSIENT ELASTOGRAPHY, MRI, MEASUREMENT OF SERUM BIOMARKERS AND LIVER BIOPSY HISTOLOGY. ALCOHOL ABSTINENCE ACHIEVED BY PSYCHOSOMATIC INTERVENTION IS THE BEST TREATMENT FOR ALL STAGES OF ALD. IN THE CASE OF ADVANCED DISEASE SUCH AS CIRRHOSIS OR HCC, LIVER TRANSPLANTATION MAY BE REQUIRED. THUS, NEW THERAPIES ARE URGENTLY NEEDED.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
9  3930  20 LIVER FIBROGENESIS: UN UPDATE ON ESTABLISHED AND EMERGING BASIC CONCEPTS. LIVER FIBROGENESIS IS DEFINED AS A DYNAMIC AND HIGHLY INTEGRATED PROCESS OCCURRING DURING CHRONIC INJURY TO LIVER PARENCHYMA THAT CAN RESULT IN EXCESS DEPOSITION OF EXTRACELLULAR MATRIX (ECM) COMPONENTS (I.E., LIVER FIBROSIS). LIVER FIBROGENESIS, TOGETHER WITH CHRONIC INFLAMMATORY RESPONSE, IS THEN PRIMARILY INVOLVED IN THE PROGRESSION OF CHRONIC LIVER DISEASES (CLD) IRRESPECTIVE OF THE SPECIFIC ETIOLOGY. IN THE PRESENT REVIEW WE WILL FIRST OFFER A SYNTHETIC AND UPDATED OVERVIEW OF MAJOR BASIC CONCEPTS IN RELATION TO THE ROLE OF MYOFIBROBLASTS (MFS), MACROPHAGES AND OTHER HEPATIC CELL POPULATIONS INVOLVED IN CLD TO THEN OFFER AN OVERVIEW OF ESTABLISHED AND EMERGING ISSUES AND MECHANISMS THAT HAVE BEEN PROPOSED TO FAVOR AND/OR PROMOTE CLD PROGRESSION. A SPECIAL FOCUS WILL BE DEDICATED TO SELECTED ISSUES THAT INCLUDE EMERGING FEATURES IN THE FIELD OF CHOLANGIOPATHIES, THE EMERGING ROLE OF GENETIC AND EPIGENETIC FACTORS AS WELL AS OF HYPOXIA, HYPOXIA-INDUCIBLE FACTORS (HIFS) AND RELATED MEDIATORS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
10  3190  37 HCV-INDUCED EPIGENETIC CHANGES ASSOCIATED WITH LIVER CANCER RISK PERSIST AFTER SUSTAINED VIROLOGIC RESPONSE. BACKGROUND & AIMS: CHRONIC HEPATITIS C VIRUS (HCV) INFECTION IS AN IMPORTANT RISK FACTOR FOR HEPATOCELLULAR CARCINOMA (HCC). DESPITE EFFECTIVE ANTIVIRAL THERAPIES, THE RISK FOR HCC IS DECREASED BUT NOT ELIMINATED AFTER A SUSTAINED VIROLOGIC RESPONSE (SVR) TO DIRECT-ACTING ANTIVIRAL (DAA) AGENTS, AND THE RISK IS HIGHER IN PATIENTS WITH ADVANCED FIBROSIS. WE INVESTIGATED HCV-INDUCED EPIGENETIC ALTERATIONS THAT MIGHT AFFECT RISK FOR HCC AFTER DAA TREATMENT IN PATIENTS AND MICE WITH HUMANIZED LIVERS. METHODS: WE PERFORMED GENOME-WIDE CHIPMENTATION-BASED CHIP-SEQ AND RNA-SEQ ANALYSES OF LIVER TISSUES FROM 6 PATIENTS WITHOUT HCV INFECTION (CONTROLS), 18 PATIENTS WITH CHRONIC HCV INFECTION, 8 PATIENTS WITH CHRONIC HCV INFECTION CURED BY DAA TREATMENT, 13 PATIENTS WITH CHRONIC HCV INFECTION CURED BY INTERFERON THERAPY, 4 PATIENTS WITH CHRONIC HEPATITIS B VIRUS INFECTION, AND 7 PATIENTS WITH NONALCOHOLIC STEATOHEPATITIS IN EUROPE AND JAPAN. HCV-INDUCED EPIGENETIC MODIFICATIONS WERE MAPPED BY COMPARATIVE ANALYSES WITH MODIFICATIONS ASSOCIATED WITH OTHER LIVER DISEASE ETIOLOGIES. UPA/SCID MICE WERE ENGRAFTED WITH HUMAN HEPATOCYTES TO CREATE MICE WITH HUMANIZED LIVERS AND GIVEN INJECTIONS OF HCV-INFECTED SERUM SAMPLES FROM PATIENTS; MICE WERE GIVEN DAAS TO ERADICATE THE VIRUS. PATHWAYS ASSOCIATED WITH HCC RISK WERE IDENTIFIED BY INTEGRATIVE PATHWAY ANALYSES AND VALIDATED IN ANALYSES OF PAIRED HCC TISSUES FROM 8 PATIENTS WITH AN SVR TO DAA TREATMENT OF HCV INFECTION. RESULTS: WE FOUND CHRONIC HCV INFECTION TO INDUCE SPECIFIC GENOME-WIDE CHANGES IN H3K27AC, WHICH CORRELATED WITH CHANGES IN EXPRESSION OF MRNAS AND PROTEINS. THESE CHANGES PERSISTED AFTER AN SVR TO DAAS OR INTERFERON-BASED THERAPIES. INTEGRATIVE PATHWAY ANALYSES OF LIVER TISSUES FROM PATIENTS AND MICE WITH HUMANIZED LIVERS DEMONSTRATED THAT HCV-INDUCED EPIGENETIC ALTERATIONS WERE ASSOCIATED WITH LIVER CANCER RISK. COMPUTATIONAL ANALYSES ASSOCIATED INCREASED EXPRESSION OF SPHK1 WITH HCC RISK. WE VALIDATED THESE FINDINGS IN AN INDEPENDENT COHORT OF PATIENTS WITH HCV-RELATED CIRRHOSIS (N = 216), A SUBSET OF WHICH (N = 21) ACHIEVED VIRAL CLEARANCE. CONCLUSIONS: IN AN ANALYSIS OF LIVER TISSUES FROM PATIENTS WITH AND WITHOUT AN SVR TO DAA THERAPY, WE IDENTIFIED EPIGENETIC AND GENE EXPRESSION ALTERATIONS ASSOCIATED WITH RISK FOR HCC. THESE ALTERATIONS MIGHT BE TARGETED TO PREVENT LIVER CANCER IN PATIENTS TREATED FOR HCV INFECTION.	2019	

11  1042  28 CLINICAL AND MOLECULAR BASIS OF HEPATOCELLULAR CARCINOMA AFTER HEPATITIS C VIRUS ERADICATION. HEPATOCELLULAR CARCINOMA (HCC) ARISES IN THE BACKGROUND OF CHRONIC LIVER DISEASES, INCLUDING HEPATITIS AND LIVER CIRRHOSIS CAUSED BY HEPATITIS C VIRUS (HCV) INFECTION. IT IS WELL KNOWN THAT HCV ERADICATION USING ANTIVIRAL DRUGS CAN EFFICIENTLY INHIBIT HEPATOCARCINOGENESIS. RECENT ADVANCES IN AND DEVELOPMENT OF DIRECT-ACTING ANTIVIRAL (DAA) DRUGS HAS REVOLUTIONIZED THE TREATMENT OF HCV INFECTION, AND THE VAST MAJORITY OF HCV PATIENTS CAN ACHIEVE HCV ERADICATION USING DAAS. HOWEVER, MOUNTING EVIDENCE CLEARLY INDICATES THAT HCC INEVITABLY OCCURS IN A SUBSET OF PATIENTS AFTER SUCCESSFUL VIRAL ERADICATION USING DAA THERAPY. CANCER IS A GENETIC DISEASE, AND THE ACCUMULATION OF GENETIC AND EPIGENETIC ABERRATIONS MAY CAUSE HEPATOCARCINOGENESIS IN CHRONICALLY DAMAGED LIVER, EVEN AFTER VIRUS ELIMINATION. IN THIS REVIEW, WE HIGHLIGHT HCC DEVELOPMENT AFTER HCV ERADICATION AND DISCUSS THE CURRENT UNDERSTANDING OF THE MOLECULAR MECHANISMS OF TUMORIGENESIS AFTER VIRUS ELIMINATION, FOCUSING ON THE GENETIC AND EPIGENETIC BACKGROUND OF CHRONICALLY DAMAGED LIVER TISSUES.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
12  6723  50 VITAMIN D RECEPTOR GENE METHYLATION IN HEPATOCELLULAR CARCINOMA. WORLDWIDE, HEPATOCELLULAR CARCINOMA (HCC) IS THE MAJOR SUBTYPE OF PRIMARY LIVER CANCERS. HCC IS TYPICALLY DIAGNOSED LATE IN ITS COURSE. WITH RESPECT TO CANCER, THE GENOMIC ACTIONS OF VITAMIN D ARE MEDIATED THROUGH BINDING TO THE VITAMIN D RECEPTOR (VDR), WHICH ALLOWS IT TO MODULATE THE EXPRESSION OF GENES IN A CELL-AND TISSUE-SPECIFIC MANNER. EPIGENETICS IS A RAPIDLY EVOLVING FIELD OF GENETIC STUDY APPLICABLE TO HCC. CHANGES IN DNA METHYLATION PATTERNS ARE THOUGHT TO BE EARLY EVENTS IN HEPATOCARCINOGENESIS. CURCUMIN HAS GREAT POTENTIAL AS AN EPIGENETIC AGENT. ACCORDINGLY, THE CURRENT STUDY HAS BEEN DESIGNED TO STUDY THE METHYLATION STATUS OF VDR GENE PROMOTER FOR THE FIRST TIME IN HCC AIMING TO FIND ITS CLINICAL SIGNIFICANCE AND POTENTIAL SCREENING ROLE IN CHRONIC LIVER DISEASE (CLD). ADDITIONALLY, WE AIMED TO INVESTIGATE, THE EFFECT OF CURCUMIN ON HCC CELL LINE, AIMING TO DISCOVER NEW THERAPEUTIC TARGETS THROUGH EPIGENETICS. THIS STUDY WAS CONDUCTED ON 45 FORMALIN-FIXED, PARAFFIN-EMBEDDED LIVER TISSUE BLOCKS INCLUDING 15 HCC SAMPLES (GROUP A), 15 CLD SAMPLES (GROUP B) AND 15 APPARENTLY NORMAL TISSUE TAKEN FROM AROUND BENIGN LESIONS (GROUP C). METHYLATION SPECIFIC RESTRICTION DIGESTION AND QPCR WERE DONE ON ALL SAMPLES AFTER DNA EXTRACTION. THE PERCENTAGE OF VDR GENE PROMOTER METHYLATION WAS SIGNIFICANTLY HIGHER IN THE HCC GROUP COMPARED TO BOTH CLD AND CONTROL GROUPS (P < 0.01). VDR PROMOTER METHYLATION BY (MS-QPCR) WAS DECREASED AND THE RELATIVE EXPRESSION OF VDR BY (QRT-PCR) WAS MARKEDLY INCREASED IN A DOSE-DEPENDENT FASHION IN CELLS GROWN IN CURCUMIN-ADEQUATE MEDIUM. IN CONCLUSION, THIS STUDY MAY OPEN A NEW GATE FOR THE USE OF VDR PROMOTER METHYLATION AS A POTENTIAL BIOMARKER IN HCC.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
13  3270  26 HEPATOCELLULAR CARCINOMA IN THE CONTEXT OF NON-ALCOHOLIC STEATOHEPATITIS (NASH): RECENT ADVANCES IN THE PATHOGENIC MECHANISMS. HEPATOCELLULAR CARCINOMA (HCC) IS THE MOST COMMON TYPE OF LIVER CANCER. HCC IS PARTICULARLY AGGRESSIVE AND IS ONE OF THE LEADING CAUSES OF CANCER MORTALITY. IN RECENT DECADES, THE EPIDEMIOLOGICAL LANDSCAPE OF HCC HAS UNDERGONE SIGNIFICANT CHANGES. WHILE CHRONIC VIRAL HEPATITIS AND EXCESSIVE ALCOHOL CONSUMPTION HAVE LONG BEEN IDENTIFIED AS THE MAIN RISK FACTORS FOR HCC, NON-ALCOHOLIC STEATOHEPATITIS (NASH), PARALLELING THE WORLDWIDE EPIDEMIC OF OBESITY AND TYPE 2 DIABETES, HAS BECOME A GROWING CAUSE OF HCC IN THE US AND EUROPE. HERE, WE REVIEW THE RECENT ADVANCES IN EPIDEMIOLOGICAL, GENETIC, EPIGENETIC AND PATHOGENIC MECHANISMS AS WELL AS EXPERIMENTAL MOUSE MODELS THAT HAVE IMPROVED THE UNDERSTANDING OF NASH PROGRESSION TOWARD HCC. WE ALSO DISCUSS THE CLINICAL MANAGEMENT OF PATIENTS WITH NASH-RELATED HCC AND POSSIBLE THERAPEUTIC APPROACHES.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
14  1354  36 DEVELOPMENT AND REGRESSION OF CIRRHOSIS. LIVER CIRRHOSIS IS THE ULTIMATE CONSEQUENCE OF THE WOUND HEALING REACTION SUBSEQUENT TO A CHRONIC INJURY, WHICH LEADS TO A COMPLETE DERANGEMENT OF THE NORMAL HEPATIC LOBULAR AND VASCULAR ARCHITECTURE. CIRRHOSIS IS CHARACTERIZED BY PATTERNS OF EVOLUTION DEPENDING ON THE CAUSATIVE AGENT AND A SERIES OF COMPLEX UNDERLINING MECHANISMS IN WHICH NEO-ANGIOGENESIS AND NECRO-INFLAMMATION PLAY A KEY ROLE. THE IMPORTANCE OF THE DIFFERENT CELL TYPES INVOLVED AND OF THE EXTRACELLULAR MATRIX COMPOSITION AS WELL AS THE ROLE OF INNATE IMMUNITY, BACTERIAL TRANSLOCATION AND OXIDATIVE STRESS ARE ALSO EMERGING. A VARIABLE DEGREE OF REGRESSION OF FIBROSIS AND EVEN CIRRHOSIS HAS BEEN DESCRIBED, IN EXPERIMENTAL MODELS, AFTER SUSPENSION OF THE LIVER DISEASE CAUSATIVE AGENT. AS SOME INDIVIDUAL FEATURES INFLUENCE THE RATE OF FIBROSIS PROGRESSION, GENETIC AND EPIGENETIC FACTORS ARE LIKELY TO INFLUENCE FIBROSIS REGRESSION. KEY MESSAGES: THERE IS INCREASING AWARENESS THAT CIRRHOSIS IS NOT A STATIC CONDITION BUT A DYNAMIC PROCESS. CURRENT SEMI-QUANTITATIVE SCORES AND CLINICAL CLASSIFICATIONS ARE INACCURATE AND UNABLE TO IDENTIFY THE DIFFERENT PHASES OF EVOLUTION OF THE ADVANCED STAGES OF CHRONIC LIVER DISEASES (CLDS). THE INCREASING AVAILABILITY OF EFFECTIVE ETIOLOGY-DRIVEN THERAPEUTIC OPTIONS FOR CLDS MAKES REVERSION OF CIRRHOSIS A MORE POSSIBLE PROSPECTIVE. HOWEVER, THE REMOVAL OF THE CAUSING AGENT, DEPENDING ON THE STAGE OF THE DISEASE, DOES NOT NECESSARILY ELIMINATE THE RISK OF DISEASE PROGRESSION, DECOMPENSATION AND DEVELOPMENT OF HEPATOCELLULAR CARCINOMA. ALSO, THE NON-INVASIVE MARKERS CURRENTLY VALIDATED FOR THE ASSESSMENT OF FIBROSIS ARE NOT SUITABLE FOR AN EFFECTIVE EVALUATION OF FIBROSIS REGRESSION. CONCLUSIONS: THERE IS A CRITICAL NEED OF A SYSTEM THAT WOULD BE ABLE TO MORE ACCURATELY DESCRIBE THE DYNAMIC DEVELOPMENT OF CIRRHOSIS AND THE IMPACT OF TISSUE FIBROSIS, NEO-ANGIOGENESIS, NECRO-INFLAMMATION AND ATTEMPTED REGENERATION ON ITS EVOLUTION. EFFECTIVE TREATMENT OF CLD CAN LEAD TO A VARIABLE DEGREE OF FIBROSIS REGRESSION. NEW MARKERS ABLE TO EVALUATE THIS PROCESS WILL NEED TO BE DETECTED AND VALIDATED.	2016	
                                                                                                                                                                                                                                                                                                                                                                          
15  4903  33 P16 PROMOTER HYPERMETHYLATION IN HUMAN HEPATOCELLULAR CARCINOMA WITH OR WITHOUT HEPATITIS VIRUS INFECTION. BACKGROUND: EPIGENETIC ALTERATION THROUGH METHYLATION IS ONE OF THE MOST IMPORTANT STEPS IN CARCINOGENESIS. HOWEVER, THE RELATION BETWEEN HEPATITIS VIRUS INFECTION AND EPIGENETIC ALTERATIONS IS POORLY UNDERSTOOD. METHODS: SIXTEEN PATIENTS WITHOUT HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV) AND 35 PATIENTS WITH HBV OR HCV WHO UNDERWENT LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA (HCC) WERE STUDIED. MUTATION OF P53 WAS DETECTED BY DIRECT SEQUENCING. METHYLATION STATUS OF P16 WAS EVALUATED IN TUMOR AND NONCANCEROUS LIVER TISSUES BY METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION. RESULTS: IN HCC WITHOUT HBV AND HCV, P53 MUTATIONS WERE DETECTED IN 5 (31%) OF 16 HCCS. METHYLATION OF P16 PROMOTER WAS DETECTED IN 2 (25%) OF 8 MODERATELY DIFFERENTIATED HCCS, 6 (75%) OF 8 POORLY DIFFERENTIATED HCCS, AND NONE OF 16 NONCANCEROUS TISSUE SPECIMENS. IN HCC WITH HBV OR HCV, P53 MUTATIONS WERE DETECTED IN 8 (23%) OF 35 HCCS. METHYLATION OF P16 PROMOTER WAS DETECTED IN 2 (100%) OF 2 WELL-DIFFERENTIATED HCCS, 13 (76%) OF 17 MODERATELY DIFFERENTIATED HCCS, 12 (75%) OF 16 POORLY DIFFERENTIATED HCCS, AND 9 (26%) OF 35 NONCANCEROUS LIVER TISSUE SPECIMENS. CONCLUSIONS: OUR RESULTS SUGGEST THAT HEPATITIS VIRUSES MIGHT INDUCE METHYLATION OF P16 PROMOTER IN LIVER WITH CHRONIC INFLAMMATION, BEFORE APPEARANCE OF HCC.	2004	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
16   442  23 ANTIVIRAL THERAPIES FOR HEPATITIS B VIRUS-RELATED HEPATOCELLULAR CARCINOMA. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS A CRITICAL RISK FACTOR FOR THE CARCINOGENESIS AND PROGRESSION OF HEPATOCELLULAR CARCINOMA (HCC). IT PROMOTES HCC DEVELOPMENT BY INDUCING LIVER FIBROGENESIS, GENETIC AND EPIGENETIC ALTERATIONS, AND THE EXPRESSION OF ACTIVE VIRAL-CODED PROTEINS. EFFECTIVE ANTIVIRAL TREATMENTS INHIBIT THE REPLICATION OF HBV, REDUCE SERUM VIRAL LOAD AND ACCELERATE HEPATITIS B E ANTIGEN SERUM CONVERSION. TIMELY INITIATION OF ANTIVIRAL TREATMENT IS NOT ONLY ESSENTIAL FOR PREVENTING THE INCIDENCE OF HCC IN CHRONIC HEPATITIS B PATIENTS, BUT ALSO IMPORTANT FOR REDUCING HBV REACTIVATION, IMPROVING LIVER FUNCTION, REDUCING OR DELAYING HCC RECURRENCE, AND PROLONGING OVERALL SURVIVAL OF HBV-RELATED HCC PATIENTS AFTER CURATIVE AND PALLIATIVE THERAPIES. THE SELECTION OF ANTIVIRAL DRUGS, MONITORING OF INDICATORS SUCH AS HBV DNA AND HEPATITIS B SURFACE ANTIGEN, AND TIMELY RESCUE TREATMENT WHEN NECESSARY, ARE ESSENTIAL IN ANTIVIRAL THERAPIES FOR HBV-RELATED HCC.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
17  4478  25 MOLECULAR PATHOGENESIS OF NONALCOHOLIC STEATOHEPATITIS- (NASH-) RELATED HEPATOCELLULAR CARCINOMA. THE PROPORTION OF OBESE OR DIABETIC POPULATION HAS BEEN ANTICIPATED TO INCREASE IN THE UPCOMING DECADES, WHICH RISES THE PREVALENCE OF NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND ITS PROGRESSION TO NONALCOHOLIC STEATOHEPATITIS (NASH). RECENT EVIDENCE INDICATES THAT NASH IS THE MAIN CAUSE OF CHRONIC LIVER DISEASES AND IT IS AN IMPORTANT RISK FACTOR FOR DEVELOPMENT OF HEPATOCELLULAR CARCINOMA (HCC). ALTHOUGH THE LITERATURE ADDRESSING NASH-HCC IS GROWING RAPIDLY, LIMITED DATA IS AVAILABLE ABOUT THE ETIOLOGY OF NASH-RELATED HCC. EXPERIMENTAL STUDIES ON THE MOLECULAR MECHANISM OF HCC DEVELOPMENT IN NASH REVEAL THAT THE CARCINOGENESIS IS RELEVANT TO COMPLEX CHANGES IN SIGNALING PATHWAYS THAT MEDIATE CELL PROLIFERATION AND ENERGY METABOLISM. GENETIC OR EPIGENETIC MODIFICATIONS AND ALTERATIONS IN METABOLIC, IMMUNOLOGIC, AND ENDOCRINE PATHWAYS HAVE BEEN SHOWN TO BE CLOSELY RELATED TO INFLAMMATION, LIVER INJURY, AND FIBROSIS IN NASH ALONG WITH ITS SUBSEQUENT PROGRESSION TO HCC. IN THIS REVIEW, WE PROVIDE AN OVERVIEW ON THE CURRENT KNOWLEDGE OF NASH-RELATED HCC DEVELOPMENT AND EMPHASIZE MOLECULAR SIGNALING PATHWAYS REGARDING THEIR MECHANISM OF ACTION IN NASH-DERIVED HCC.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
18  6868  25 [PATHOGENESIS OF HEPATITIS B VIRUS-RELATED HEPATOCELLULAR CARCINOMA]. HEPATOCELLULAR CARCINOMA (HCC) IS ONE OF THE MOST COMMON CANCER WORLDWIDE. MOST OF THE HCC OCCUR IN DEVELOPING COUNTRIES. CHRONIC HEPATITIS B VIRUS (HBV) INFECTION IS AN IMPORTANT RISK FACTOR FOR HCC DEVELOPMENT. HBV INDUCES IMMUNE-MEDIATED CHRONIC HEPATITIS, LIVER INJURY, REGENERATION AND SCAR FORMING RESPONSES, LEADING TO AN INFLAMMATORY, FIBROTIC AND IMMUNE DEFICIENT MICROENVIRONMENT. HBV MAY INTEGRATE INTO HOST GENOME, INDUCING GENETIC ABNORMALITY AND ALTERING THE EXPRESSION OF HCC-RELATED GENES. HBV ALSO EXPRESSES ACTIVE PROTEINS SUCH AS X (HBX) AND S PROTEINS, WHICH MAY TRANS-ACTIVATE HCC-RELATED PROTEINS EXPRESSION, INTERACT WITH INTRACELLULAR SPECIFIC PROTEINS, ACTIVATE A VARIETY OF SIGNALING PATHWAYS, AND INDUCE ABERRANT EPIGENETIC MODIFICATIONS. HBV MUTATION ALSO HAS IMPACT ON HBV RELATED HCC DEVELOPMENT.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
19  2980  37 GENETIC BASIS OF HEPATITIS VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA: LINKAGE BETWEEN INFECTION, INFLAMMATION, AND TUMORIGENESIS. HEPATITIS VIRUS INFECTION IS A LEADING CAUSE OF CHRONIC LIVER DISEASE, INCLUDING CIRRHOSIS AND HEPATOCELLULAR CARCINOMA (HCC). ALTHOUGH ANTI-VIRAL THERAPIES AGAINST HEPATITIS B VIRUS (HBV) AND HEPATITIS C VIRUS (HCV) HAVE DRAMATICALLY PROGRESSED DURING THE PAST DECADE, THE ESTIMATED NUMBER OF PEOPLE CHRONICALLY INFECTED WITH HBV AND/OR HCV IS ~370 MILLION, AND HEPATITIS VIRUS-ASSOCIATED HEPATOCARCINOGENESIS IS A SERIOUS HEALTH CONCERN WORLDWIDE. UNDERSTANDING THE MECHANISM OF VIRUS-ASSOCIATED CARCINOGENESIS IS CRUCIAL TOWARD BOTH TREATMENT AND PREVENTION, AND THE RECENTLY DEVELOPED WHOLE GENOME/EXOME SEQUENCING ANALYSIS USING NEXT-GENERATION SEQUENCING TECHNOLOGIES HAS CONTRIBUTED TO UNVEILING THE LANDSCAPE OF GENETIC AND EPIGENETIC ABERRATIONS IN NOT ONLY TUMOR TISSUES BUT ALSO THE BACKGROUND LIVER TISSUES UNDERLYING CHRONIC LIVER DAMAGE CAUSED BY HEPATITIS VIRUS INFECTION. SEVERAL MAJOR MECHANISMS UNDERLIE THE GENETIC AND EPIGENETIC ABERRATIONS IN THE HEPATITIS VIRUS-INFECTED LIVER, SUCH AS THE GENERATION OF REACTIVE OXIDATIVE STRESS, ECTOPIC EXPRESSION OF DNA MUTATOR ENZYMES, AND DYSFUNCTION OF THE DNA REPAIR SYSTEM. IN ADDITION, DIRECT ONCOGENIC EFFECTS OF HEPATITIS VIRUS, REPRESENTED BY THE INTEGRATION OF HBV-DNA, ARE OBSERVED IN INFECTED HEPATOCYTES. ELUCIDATING THE WHOLE PICTURE OF GENETIC AND EPIGENETIC ALTERATIONS, AS WELL AS THE MECHANISMS OF TUMORIGENESIS, WILL FACILITATE THE DEVELOPMENT OF EFFICIENT TREATMENT AND PREVENTION STRATEGIES FOR HEPATITIS VIRUS-ASSOCIATED HCC.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
20  3274  32 HEPATOCELLULAR CARCINOMA: THE VIRUS OR THE LIVER? HEPATOCELLULAR CARCINOMA (HCC) REPRESENTS A MAJOR PUBLIC HEALTH PROBLEM BEING ONE OF THE MOST COMMON CAUSES OF CANCER-RELATED DEATHS WORLDWIDE. HEPATITIS B (HBV) AND C VIRUSES HAVE BEEN CLASSIFIED AS ONCOVIRUSES AND ARE RESPONSIBLE FOR THE MAJORITY OF HCC CASES, WHILE THE ROLE OF HEPATITIS D VIRUS (HDV) IN LIVER CARCINOGENESIS HAS NOT BEEN ELUCIDATED. HDV/HBV COINFECTION IS RELATED TO MORE SEVERE LIVER DAMAGE THAN HBV MONO-INFECTION AND RECENT STUDIES SUGGEST THAT HDV/HBV PATIENTS ARE AT INCREASED RISK OF DEVELOPING HCC COMPARED TO HBV MONO-INFECTED PATIENTS. HBV IS KNOWN TO PROMOTE HEPATOCARCINOGENESIS VIA DNA INTEGRATION INTO HOST DNA, DISRUPTION OF MOLECULAR PATHWAYS BY REGULATORY HBV X (HBX) PROTEIN AND EXCESSIVE OXIDATIVE STRESS. RECENTLY, SEVERAL MOLECULAR MECHANISMS HAVE BEEN PROPOSED TO CLARIFY THE PATHOGENESIS OF HDV-RELATED HCC INCLUDING ACTIVATION OF SIGNALLING PATHWAYS BY SPECIFIC HDV ANTIGENS, EPIGENETIC DYSREGULATION AND ALTERED GENE EXPRESSION. ALONGSIDE, ONGOING CHRONIC INFLAMMATION AND IMPAIRED IMMUNE RESPONSES HAVE ALSO BEEN SUGGESTED TO FACILITATE CARCINOGENESIS. FINALLY, CELLULAR SENESCENCE SEEMS TO PLAY AN IMPORTANT ROLE IN CHRONIC VIRAL INFECTION AND INFLAMMATION LEADING TO HEPATOCARCINOGENESIS. IN THIS REVIEW, WE SUMMARIZE THE CURRENT LITERATURE ON THE IMPACT OF HDV IN HCC DEVELOPMENT AND DISCUSS THE POTENTIAL INTERPLAY BETWEEN HBV, HDV AND NEIGHBOURING LIVER TISSUE IN LIVER CARCINOGENESIS.	2023