Chronic intermittent
hypoxia, a characteristic of
obstructive sleep apnea (OSA), is associated with the progression of simple hepatic steatosis to necroinflammatory
hepatitis. We determined whether inhibition of a
hypoxia-induced signaling pathway could attenuate
hypoxia-exacerbated lipoapoptosis in human hepatocytes. The human
hepatocellular carcinoma cell line (HepG2) was used in this study.
Palmitic acid (PA)-treated groups were used for two environmental conditions:
Hypoxia (1% O2) and normoxia (20% O2). Following the treatment, the cell viability was determined by the 3,4-(5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium
salt (MTS) assay, and the mechanism of lipoapoptosis was evaluated by Western blotting.
Hypoxia exacerbated the suppression of hepatocyte growth induced by
palmitic acid via activation of mitochondrial apoptotic pathways as a result of endoplasmic reticulum (ER) and oxidative stresses.
Ammonium pyrrolidine dithiocarbamate, a scavenger of
reactive oxygen species, attenuated the
hypoxia-exacerbated lipoapoptosis in hepatocytes, whereas
glycerol, which reduces ER stress, did not. This may have been because inhibition of oxidative stress decreases the expression of
pro-apoptotic proteins, such as
caspase 9 and
cytochrome c. These results suggested that modulation of apoptotic signaling pathways activated by oxidative stress can aid in identifying novel therapeutic strategies for the treatment of
nonalcoholic steatohepatitis (NASH) with OSA. Further in vivo studies are necessary to understand the pathophysiologic mechanism of NASH with OSA and to prove the
therapeutic effect of the modulation of the signaling pathways.