g., Bcl-2–associated X protein [Bax], Bcl-2 homologous antagonist/killer [Bak]) and (2) BH3-only proteins, which lack BH1, BH2, and BH4 domains (e.g., Bid, Noxa, Puma [p53 up-regulated modulator of apoptosis]). BH3-only proteins initiate the mitochondrial Temozolomide in vivo signaling cascade by sensing cellular damage.7 After activation, BH3-only proteins are released to neutralize antiapoptotic Bcl-2 proteins. Subsequently, Bax and Bak trigger mitochondrial membrane leakage and the release of mitochondrial proteins, including cytochrome c, Smac/DIABLO (second mitochondria-derived activator of caspases/direct IAP-binding protein with low pI), and apoptosis-inducing

factor (AIF). Smac/DIABLO proteins inactivate the inhibitors of apoptosis protein (IAP) family, which consists of IAP1/2, BRUCE, NAIP, ILP2, ML-IAP, Survivin, and X-linked Palbociclib IAP (XIAP). XIAP is a direct caspase inhibitor. Other IAPs including Survivin have several functions apart from caspase inhibition, e.g., triggering of ubiquitination processes.8 Antiapoptotic Bcl-2 family members (e.g., Bcl-2, Bcl-xL, and myeloid cell leukemia-1 [Mcl-1]), interact with Bax and Bak to inhibit the activation of mitochondria.7 Both Bcl-xL and Mcl-1 have been identified as major antiapoptotic Bcl-2 proteins in the liver.9–11

Liver homeostasis is severely disturbed in Mcl-1Δhep mice.10, 11 Spontaneous hepatocyte apoptosis was observed in livers of Mcl-1Δhep mice resulting in profound liver cell damage and increased susceptibility of hepatocytes toward proapoptotic stimuli.10 In addition, Mcl-1 has been shown to be highly expressed in a subset of human HCC, contributing to apoptosis resistance of cancer cells.12, 13 Thus,

abrogation of the prosurvival function of Mcl-1, either by (1) diminishing its levels or (2) by inactivating its function, have shown promising results with regards to treatment of HCC.12, 13 In this study, we show that liver-specific depletion of Mcl-1 increases hepatocyte apoptosis, induces hepatocellular Phloretin proliferation, and causes HCC in the absence of overt inflammation. aCGH, array-based comparative genomic hybridization; ALT, alanine aminotransferase; AST, aspartate aminotransferase; Bcl-2, B cell lymphoma-2; BrdU, bromodeoxyuridine; GAPDH, glyceraldehyde 3-phosphate dehydrogenase; HCC, hepatocellular carcinoma; IAP, inhibitors of apoptosis protein; IFN, interferon; IL, interleukin; mRNA, messenger RNA; Mcl-1, myeloid cell leukemia-1; RT-PCR, real-time polymerase chain reaction; TGF, transforming growth factor; TUNEL, terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling; WT, wild-type. Conditional liver-specific Mcl-1 knockout mice (homozygous: Mcl-1flox/flox-AlbCre, referred to as Mcl-1Δhep; heterozygous: Mcl-1flox/wt -AlbCre referred to as Mcl-1flox/wt; and control littermates: Mcl-1wt/wt) were generated and genotyped as described.10 Animal experiments were performed as described elsewhere.