The aim of this study was to test whether long-term
ethanol consumption confers therapeutic resistance to human
liver cancer patients infected with hepatitis B virus (HBV). Chronic
ethanol-treated cells were established by consecutively culturing a human
hepatocellular carcinoma cell line, Hep 3B, which contains integrated HBV sequences, for 20-40 passages with or without 10 mM
ethanol (designated as E20-E40 and C20-C40, respectively). Flow cytometry analysis demonstrated that a growth promoting effect of long-term
ethanol treatment was induced in the E40 cells through preferential acceleration of S-phase in these cells. Lower
protein expression levels of p16, p21/Cip1, and p27/Kip1 were detected in the
ethanol-treated E40 cells. We further demonstrated that long-term
ethanol-treated E40 cells develop drug resistance in response to
mitomycin C (MMC) treatment (>8 microM). Immunoblot analysis revealed that caspase-8-mediated mitochondrial apoptotic signals (such as Bad) were inactivated in the MMC-resistant E40 cells. Immunoprecipitation experiments demonstrated that the sequestration of phosphorylated Bad (Ser-112) through its binding with 14-3-3 was detected more profoundly in the MMC-resistant E40 cells. Next, we examined the therapeutic efficacy of MMC (10 mg MMC/kg
body weight, three times per week) in severe combined immunodeficient (SCID) mice bearing E40- and C40-xenografted
tumors. Significant reductions (>3-fold) in
tumor growth were detected in MMC-treated C40-xenografted mice. In vivo and in vitro studies demonstrated that AKT- and
extracellular signal-regulated kinase (ERK)-mediated survival factors inhibited the Bad-induced mitochondrial apoptotic signals that were involved in E40
tumor cells and that conferred resistance to MMC.