Radiotherapy is commonly used in treating many kinds of cancers that cannot be cured by other therapeutic strategies. However, radiation-induced fibrosis in the treatment of intrahepatic cancer is a major obstacle. Hedgehog pathway is known to regulate the fibrotic process and proliferation of progenitor cells. Hedgehog ligands act as a profibrotic factor and hedgehog-responsive cells undergo epithelial-to-mesenchymal transition (EMT), eventually contributing to the fibrogenic process. Herein, we investigated whether the hedgehog pathway was associated with radiation-induced hepatic fibrosis. Female mice were irradiated with a single dose of 20 Gy and were sacrificed 1 week postirradiation, to obtain the livers for biochemical and histological analysis. Hematoxylin and eosin and Sirius Red staining were used in evaluating liver morphology and fibrosis, respectively. Immunochemical staining for active caspase 3 and CD44 was used to examine the repair response of the irradiated livers. Immunoblot analysis was performed to detect the expression of hedgehog molecules and fibrogenic markers. Fat accumulation in hepatocytes and increased apoptosis were observed in liver sections from mice treated with radiation. Expression of hedgehog ligand, Indian hedgehog, and hedgehog target gene, Gli2, were significantly up-regulated in the liver of mice treated with radiation. Levels of transforming growth factor-β (inducer of fibrosis) and α-smooth muscle actin (marker of myofibroblastic hepatic stellate cells) were also greatly increased in the damaged liver compared to the normal liver. The EMT marker, laminin-β3, showed a great increase, whereas EMT inhibitor, bmp7, was significantly decreased in mouse liver postirradiation. Furthermore, CD44-positive progenitors were shown to accumulated in the injured liver. These results suggest that increased expression of hedgehog signaling promotes proliferation of myofibroblastic hepatic stellate cells and progenitors, and thereby contributes to the repair response after irradiation.
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Vol. 179 • No. 1