1. Introduction
Hepatocellular carcinoma (HCC), accounting for over 90% cases of primary liver tumors, is a common malignant tumor. Its occurrence is a complex process with multiple etiologies and steps. Risk factors include viral hepatitis (hepatitis B and C), alcoholic liver disease, male sex, and non-alcoholic fatty liver disease (NAFLD) [
1]. HCC with NAFLD without advanced fibrosis is more common in men than in women and characterized by large tumor size [
2]. However, few studies have identified lipid reprogramming features of HCC genesis with gender disparity.
Energy metabolism changes are the cornerstone of hepatocellular tumor initiation and adaptation [
3]. In addition to activating glycolysis, lipid metabolism reprogramming helps hepatoma deal with metabolic stress, as evidenced by increased fatty acid (FA) oxidation, and highly depends on lipids through external uptake and
de novo lipogenesis [
4]. Additionally, the multiple functions of lipids in cell signaling and membrane composition are also critical to cancer cells [
5]. Lipids can promote tumor activity [
6]. Therefore, studies on the role of lipid metabolism in HCC could explain tumor occurrence and development. Lipidomicsis a main branch of metabolomics proposed in 2003 [
7]. In recent years, non-targeted lipidomic approaches have been widely used in the study of various liver diseases to search for disease and drug mechanisms or key lipid biomarkers. However, the research of lipid metabolism disorders in sex-biased HCC is limited.
Ras signal transduction pathway abnormalities are associated with many cellular processes, such as cell survival and proliferation, and commonly involved in malignant transformation, including to HCC [
8]. The Ras pathway is ubiquitously activated in HCC [
9] and plays a prognostic role.
Raf-1 and
pMEK1 are overexpressed in patients with HCC with short survival, and
Raf-1 overexpression is an independent biological marker for early tumor recurrence and poor prognosis [
10]. The relationship between the Ras pathway and lipids is intertwined and multifaceted. For example, Ras modulates tumor invasion and metastasis by regulating the lipid metabolism; FAs help cope with Ras oncogenic stress; lipids reversibly regulate the localization and function of Ras proteins [
11]. However, the revealed correlations require further investigation.
In the present study, lipidomics was performed on a Hras12V transgenic (Ras-Tg) mice model of HCC induced by liver-specific activation of the Ras signal pathway with characteristics of lipid metabolism disorder and male predilection [
12,
13]. The revealed systematic feature of lipid expression profiles in
Ras oncogene-induced hepatocarcinogenesis with sex disparity casts new lights on our understanding of the underlying intracellular mechanisms in male-biased HCC.
3. Discussion
Glycerolipids are involved in cell functions and cancer progression [
17]. TG, an important compound for energy storage, is significantly elevated in both human and mouse HCC for rapid growth of hepatoma [
18,
19]. DG, a signaling molecule related to tumor promotion and carcinogenesis through activation of protein kinase C, is also elevated in HCC [
19,
20]. Consistently, our data showed that the levels of TG and DG were elevated in HCC (
Figure 2A,
Figure 4B and
Figure S2). This was further supported by the fact that the upregulated key enzymes prompt adequate FA supplementation in HCC (
Figure 6). Further, glycerolipids were concentrated in zone 3 of the hepatic lobules, which coincided with the original location of hepatic tumorigenesis (data not shown), indicating that the accumulation and inhomogeneous distribution of glycerolipids may be closely related to hepatocarcinogenesis. Laboratory investigations of the underlying mechanisms are underway.
Glycerophospholipids perform biological functions, such as biofilm composition and signal transduction, and their metabolic dysregulation affects cancer progression [
21]. They are elevated in many types of cancer [
21]. However, in HCC, their metabolic alteration is complicated. Glycerophospholipid profiles in HCC and adjacent liver tissues differ across clinical reports. In some reports, the total glycerophospholipid concentration and/or the levels of their subclasses were significantly or nonsignificantly lower in HCC tissues than in adjacent tissues [
22,
23,
24]. However, in other reports, PC and PE levels were elevated in HCC [
25]. Because the etiological effects on clinical HCC are complex and difficult to distinguish, animal models are powerful tools to determine the different changes in glycerophospholipid profiles of HCC in response to different etiologies. In a mouse model, HCC induced by activated mammalian target of rapamycin (mTOR) signal transduction specifically resulted in reduced PC and PE levels and elevated PI and CL levels [
26]. However, in HCC induced by diethylnitrosamine injections, the levels of PC, PE, PS, and PI did not differ significantly from those of surrounding tissues [
19].
In the present study, the proportion and relative level of total glycerophospholipids were lower in T than in P in both sexes (
Figure 2B and
Figure S2). PC, PE, LPC and PS levels were lower in T than in P (the decreasing trend of PE and LPC in females did not reach the level of significance), consistent with the overall trend (
Figure 2B). These findings were further supported by the downregulated key enzymes in glycerophospholipid synthesis (
Figure 6). Consistent with these findings, a choline deficiency diet may lead to HCC, and dietary PC supplementation can induce apoptosis to prevent HCC [
27]. Additionally, reduced PC synthesis in human HCC cells increases the nuclear localization of SREBP-1 and lipogenesis [
28]. Contrary to the decreasing trend in total glycerophospholipid levels, PI did not change significantly or even increased slightly in T compared with P (
Figure 2B). Several phosphorylated PIs not included in the DELs in this study were obviously higher in T than in P (e.g., PIP2 O-39:3,
p = 0.098 in males and
p = 0.051 in females) (
Table S3), and PIP2 is a direct substrate of phosphoinositide 3-kinase (PI3K). Consistent with these findings, PIs are often exploited by cancer cells to fuel pro-proliferative signaling, such as the PI3K/Akt/mTOR signaling pathway that is involved in tumorigenesis and progression of HCC [
29,
30]. Thus, disorders of glycerophospholipids may be involved in
Ras oncogene-induced HCC and provide important clues for the clinical investigation of Ras signaling-involved HCC.
MUFAs promote cancer cell survival by inducing autophagy, enhancing cell membrane turnover, affecting intracellular signaling and gene transcription, and increasing energy production [
31]. In human HCC, the MUFA levels are increased [
32]. Accordingly, the expression of stearoyl-CoA desaturase-1 (SCD1), a key enzyme that converts SFA into MUFA, is up-regulated [
33], and can even be used as a biomarker for the progression and prognosis of HCC [
4]. Additionally, suppression of SCD1 inhibits the proliferation of human HCC cell lines by depleting MUFA [
34]. Moreover, SCD1 consumes SFA and enables cancer cells to escape cell stress response and apoptosis [
31,
35]. Consistently, MUFA levels are elevated in mouse HCC [
36]. In several studies, SCD2 undergoes significant upregulation regardless of SCD1 changes and is involved in pro-carcinogenic processes in mouse HCC induced by various factors, although SCD1 is the major isoform in the adult mouse liver [
37,
38,
39]. This finding was further confirmed in the present study. The level of MUFA were elevated in HCC of Ras-Tg mice (
Figure 3A,B). Accordingly, the expression of SCD2 was strongly upregulated (
Figure 3C,D). Additionally, oleic acid (C18:1) drives HCC progression [
40]. Among the MUFAs in the present study, oleic acid, as the main product of SCD, was significantly elevated (
Figure 3C). These data combined with the published evidences suggested that SCD-induced upregulation of MUFA and oleic acid were involved in the occurrence and development of HCC. Therefore, targeted drug therapy involving MUFA may be an effective clinical treatment of HCC.
Additionally, the optimal MUFA/PUFA ratio is necessary to maintain normal biophysical properties of cell membranes and cell function, and its imbalance is responsible for many diseases, including HCC [
32,
41]. PC is the most abundant glycerophospholipid in cell membrane. In human and rodent HCC, PUFA-PC levels are reduced, while MUFA-PC levels are significantly elevated compared to peri-tumor tissues [
42]. A higher MUFA/PUFA ratio may result from oxidative stress in many tumors, while reduced binding of PUFA to membrane glycerophospholipids promotes resistance to lipid peroxidation and iron death in HCC [
32]. This study also showed a significantly higher MUFA-PC/PUFA-PC ratio (
Figure S2), supporting the involvement of the MUFA/PUFA ratio in membrane PC in HCC.
Sex disparities in hepatocarcinogenesis have been well recognized. However, whether or not sex disparity is present in developed HCC remains controversial. As sex hormones are involved in normal hepatocyte function as well as hepatocarcinogenesis, HCC may be suitable for resistance hormone therapy [
43]. In one study, 17-β-estradiol and its compounds diethylstilbestrol, tamoxifen, and genistein-induced apoptosis in human hepatoma Hep3B cells [
44]. In an animal model, cyproterone acetate inhibited the growth of androgen receptor-positive HCC transplanted in nude male mice [
45]. In some studies, tamoxifen improved survival in patients with advanced HCC. However, in most studies, HCC was not a sex hormone-responsive tumor clinically because once the tumor developed, the anti-estrogen or anti-androgen therapy showed no anti-tumor effect or survival benefit [
43,
46]. Differences in protein expression profiles were significantly reduced in T compared to P or W between sexes [
16]. Correspondingly, the expressions of androgen receptor (Ar) and estrogen receptor 1 (Esr1) and their corresponding genes changed significantly during hepatocarcinogenesis and finally resulted in no differences in T between sexes [
16]. Consistently, the present study showed significantly attenuated differences in lipid profiles of T between sexes (
Figure 7). These data suggested that sex characteristics in developed HCC were significantly attenuated, which supported the clinical loss of efficacy of sex hormone-dependent therapy.
Although the aforementioned evidence showed convergence in developed HCC, sexes showed significant differences during carcinogenesis. Because HCC is generally found late, collecting clinical samples of early liver lesions is difficult for systematic studies on the role of lipid metabolism disorders in the occurrence of sex-biased HCC. This was the first study to systematically describe the differential lipid metabolism disorder between sexes in hepatocarcinogenesis. Our data showed that in male mice, P had obviously higher glycerolipid and glycerophospholipid levels compared to W. However, in female mice, glycerolipid levels were significantly reduced, but glycerophospholipid levels did not change (
Figure 2). In addition, male mice had a higher number of DELs than female mice in P/W comparisons, especially up-regulated DELs (
Figure 4). This male-biased dysregulation of lipid metabolism has also been described in human HCC in that Liver X Receptor (LXR) and Retinoid X Receptor (RXR), which regulate lipid metabolism, are activated only in men with HCC [
47]. These evidences suggest that lipid disorders in men are associated with male-biased HCC.
The male and female livers respond differently to the
Ras oncogene. As aforementioned, more severe lipid disorganization in the male liver promotes the male propensity for HCC development. In addition, sex-dimorphic gene expression in the male and female livers [
48], which translates into sex-specific differences in lipids, drugs, steroid hormones, and the xenobiotics metabolism [
49], causes the sex bias in HCC. Our study showed different protein expression profiles between the wild-type male and female mouse livers [
16], significant differences in lipid characteristics in W of the male and female mice, more abundant glycerolipids and fewer sphingolipids in the female livers (
Figure 2,
Table S2). Although the levels of some lipid species in W varied significantly between sexes, these differences were reduced in the context of Ras oncogene expression (
Figure 7 and
Figure S2;
Table S5). Except for PA, LBPA, and LPC, none of the lipid subclasses in P differed significantly between sexes (
Table S2), indicating the homogeneity of hepatic lipid levels in male and female mice harboring the
Ras oncogene. In our previous study, the
Ras oncogene expression reduced the sex disparity in hepatocytes by attenuating sex hormone-related pathways and thereby attenuating the influence of sex hormones on hepatocarcinogenesis [
16]. However, Ar and Esr1 still showed sexually dimorphic expressions in P [
16], suggesting that Ras activation may affect lipid disorders in male mice through pathways other than the sex hormone pathway.
Lipids are the main component of organisms and cells and highly diverse in structure and distribution. Moreover, lipid metabolism is a complex network involving multiple isozymes and multifunctional enzymes. Understanding the biological relevance of this diversity and why cancer is associated with severe lipid disorders are fundamental challenges in biology. Further studies integrating multiomics analyses, such as genomics, transcriptomics, proteomics, metabolomics, and functionomics, are required and would provide multiple perspectives to improve our understanding of disordered lipid metabolisms in hepatocarcinogenesis with sex disparity. In addition, owing to the male predilection of HCC in the Ras-Tg model, 9-month-old male and 15-month-old female mice were selected to achieve our research goals. However, age may be a factor affecting the results of the analysis. Moreover, lipid metabolism, especially in liver tissue, is strongly influenced by fluctuations in plasma sex hormones during the oestrus cycle for the female cohort. Therefore, oestrus cycle should be considered in future studies.
Abbreviations
HCC, Hepatocellular carcinoma; Ras-Tg, Hras12V transgenic mice; Wt, wild-type mice; W, liver tissues of Wt; P, Peri-tumor tissues of Ras-Tg; T, HCC tissues of Ras-Tg; 9M, 9-month-old; 15M, 15-month-old; F, female; M, male; DELs, Differentially expressed lipids; PCA, Principal component analysis; VIP, Variable importance of projection; TG, triacylglycerol; TG-O, alkyldiacylglycerol; DG, diacylglycerol; PC, phosphatidylcholine; PE, phosphatidylethanolamine; PG, phosphatidylglycerol; PI, phosphatidylinositol; PS, phosphatidylserine; PA, phosphatidic acid; LBPA, lysobisphosphatidic acid; LPC, lysophosphatidylcholine; LPE, Lysophosphatidylethanolamine; LPI, Lysophosphatidylinositol; LPG, lysophosphatidylglycerol; SM, sphingomyelin; phSM, phytosphingosine; Cer, ceramide; FA, Fatty acid; SFA, Saturated fatty acid; UFA, Unsaturated fatty acids; MUFA, Monounsaturated fatty acid; PUFA, Polyunsaturated fatty acid.