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Mocci S, Perra A, Littera R, Pes F, Melis M, Sanna C, Mascia A, Murgia M, Mereu C, Lorrai M, Duś-Ilnicka I, Zedda G, Lai S, Giuressi E, Guarino F, Serra G, Miglianti M, Stradoni R, Vacca M, Zolfino T, Chessa L, Giglio S. Human leukocyte antigen-G in hepatocellular carcinoma driven by chronic viral hepatitis or steatotic liver disease. Sci Rep 2025; 15:13331. [PMID: 40246934 PMCID: PMC12006299 DOI: 10.1038/s41598-025-97406-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Accepted: 04/04/2025] [Indexed: 04/19/2025] Open
Abstract
Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and the third leading cause of cancer-related mortality, primarily driven by viral infections (HCV, HBV) and steatotic liver diseases (SLD). Despite advances in treatment, early detection and accurate prognosis remain challenging. The Human leukocyte antigen G (HLA-G) molecule is dysregulated in various conditions, including cancers and viral infections. This study aimed to investigate HLA-G's role in viral-related and SLD-driven HCC. We analyzed a cohort of 116 HCC patients and 140 healthy controls to assess HLA-G genetic variants and soluble levels. Results showed significantly higher levels of soluble HLA-G in HCC patients compared to controls (Pc = 0.003). Moreover, overall survival (OS) was significantly lower in patients with the extended HLA-G*01:01:01/UTR-1 haplotype (Log-rank test, p = 0.002), a trend consistent in both HCV and/or HBV-related HCC (p = 0.025) and SLD-related HCC (p = 0.018). Elevated sHLA-G levels were associated with shorter OS across both subgroups (p = 0.034 (HBV/HCV) and p = 0.010 (SLD), respectively). The findings suggest that elevated levels of soluble HLA-G and specific genetic variants are associated with poor prognosis in HCC patients, highlighting the potential of HLA-G as a prognostic biomarker in both viral-related and steatotic liver disease-related HCC.
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Affiliation(s)
- Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
- Center for Research University Services (CeSAR), University of Cagliari, Cagliari, Italy.
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research On Transplantation), Cagliari, Italy
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Roberto Littera
- AART-ODV (Association for the Advancement of Research On Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research On Transplantation), Cagliari, Italy
| | - Celeste Sanna
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessia Mascia
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Michela Murgia
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Caterina Mereu
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michela Lorrai
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Irena Duś-Ilnicka
- Department of Oral Pathology, Wrocław Medical University, Wrocław, Poland
| | - Giorgia Zedda
- Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Cagliari, Italy
| | | | - Federico Guarino
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Gianfranco Serra
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberta Stradoni
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Vacca
- AART-ODV (Association for the Advancement of Research On Transplantation), Cagliari, Italy
| | | | - Luchino Chessa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Center for Research University Services (CeSAR), University of Cagliari, Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Cagliari, Italy
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Littera R, Perra A, Miglianti M, Piras IS, Mocci S, Lai S, Melis M, Zolfino T, Balestrieri C, Conti M, Serra G, Figorilli F, Firinu D, Onali S, Matta L, Porcu C, Pes F, Fanni D, Manieli C, Vacca M, Cusano R, Trucas M, Cipri S, Tranquilli S, Rassu S, Cannas F, Carta MG, Kowalik MA, Giuressi E, Faa G, Chessa L, Giglio S. The double-sided of human leukocyte antigen-G molecules in type 1 autoimmune hepatitis. Front Immunol 2022; 13:1007647. [PMID: 36311782 PMCID: PMC9597675 DOI: 10.3389/fimmu.2022.1007647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED The immunomodulatory effects of HLA-G expression and its role in cancers, human liver infections and liver transplantation are well documented, but so far, there are only a few reports addressing autoimmune liver diseases, particularly autoimmune hepatitis (AIH). METHOD AND MATERIALS We analyzed the genetic and phenotypic characteristics of HLA-G in 205 type 1 AIH patients (AIH-1) and a population of 210 healthy controls from Sardinia (Italy). RESULTS Analysis of the HLA-G locus showed no substantial differences in allele frequencies between patients and the healthy control population. The HLA-G UTR-1 haplotype was the most prevalent in both AIH-1 patients and controls (40.24% and 34.29%). Strong linkage was found between the HLA-G UTR-1 haplotype and HLA-DRB1*03:01 in AIH-1 patients but not controls (D' = 0.92 vs D' = 0.50 respectively; P = 1.3x10-8). Soluble HLA-G (sHLA-G) levels were significantly lower in AIH-1 patients compared to controls [13.9 (11.6 - 17.4) U/mL vs 21.3 (16.5 - 27.8) U/mL; P = 0.011]. Twenty-four patients with mild or moderate inflammatory involvement, as assessed from liver biopsy, showed much higher sHLA-G levels compared to the 28 patients with severe liver inflammation [33.5 (23.6 - 44.8) U/mL vs 8.8 (6.1 - 14.5) U/mL; P = 0.003]. Finally, immunohistochemistry analysis of 52 liver biopsies from AIH-1 patients did not show expression of HLA-G molecules in the liver parenchyma. However, a percentage of 69.2% (36/52) revealed widespread expression of HLA-G both in the cytoplasm and the membrane of plasma cells labeled with anti-HLA-G monoclonal antibodies. CONCLUSION This study highlights the positive immunomodulatory effect of HLA-G molecules on the clinical course of AIH-1 and how this improvement closely correlates with plasma levels of sHLA-G. However, our results open the debate on the ambiguous role of HLA-G molecules expressed by plasma cells, which are pathognomonic features of AIH-1.
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Affiliation(s)
- Roberto Littera
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ignazio S. Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Teresa Zolfino
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | | | - Maria Conti
- Liver Unit, University Hospital, Cagliari, Italy
| | | | - Francesco Figorilli
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Simona Onali
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Matta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Carmen Porcu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Fanni
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Cristina Manieli
- Department of Pathological Anatomy, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- Biomedical Sector, Center for Advanced Studies, Research and Development (CRS4), Cagliari, Italy
| | - Marcello Trucas
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Selene Cipri
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marta Anna Kowalik
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Gavino Faa
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, University Hospital, Cagliari, Italy
| | - Sabrina Giglio
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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Mestrallet G, Rouas-Freiss N, LeMaoult J, Fortunel NO, Martin MT. Skin Immunity and Tolerance: Focus on Epidermal Keratinocytes Expressing HLA-G. Front Immunol 2021; 12:772516. [PMID: 34938293 PMCID: PMC8685247 DOI: 10.3389/fimmu.2021.772516] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/16/2021] [Indexed: 12/27/2022] Open
Abstract
Although the role of epidermal cells in skin regeneration has been extensively documented, their functions in immunity and tolerance mechanisms are largely underestimated. The aim of the present review was to outline the state of knowledge on resident immune cells of hematopoietic origin hosted in the epidermis, and then to focus on the involvement of keratinocytes in the complex skin immune networks acting in homeostasis and regeneration conditions. Based on this knowledge, the mechanisms of immune tolerance are reviewed. In particular, strategies based on immunosuppression mediated by HLA-G are highlighted, as recent advances in this field open up perspectives in epidermis-substitute bioengineering for temporary and permanent skin replacement strategies.
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Affiliation(s)
- Guillaume Mestrallet
- Commissariat ã l'Energie Atomique et aux Energies Alternatives, DRF, Francois Jacob Institute of Biology, Laboratory of Genomics and Radiobiology of Keratinopoiesis, Institute of Cellular and Molecular Radiobiology, Evry, France.,Université Paris-Saclay, Saint-Aubin, France
| | - Nathalie Rouas-Freiss
- Commissariat ã l'Energie Atomique et aux Energies Alternatives, DRF, Francois Jacob Institute of Biology, Hemato-Immunology Research Department, Saint-Louis Hospital, Paris, France.,Université de Paris, UMR-S 976 HIPI Unit, Paris, France
| | - Joel LeMaoult
- Commissariat ã l'Energie Atomique et aux Energies Alternatives, DRF, Francois Jacob Institute of Biology, Hemato-Immunology Research Department, Saint-Louis Hospital, Paris, France.,Université de Paris, UMR-S 976 HIPI Unit, Paris, France
| | - Nicolas O Fortunel
- Commissariat ã l'Energie Atomique et aux Energies Alternatives, DRF, Francois Jacob Institute of Biology, Laboratory of Genomics and Radiobiology of Keratinopoiesis, Institute of Cellular and Molecular Radiobiology, Evry, France.,Université Paris-Saclay, Saint-Aubin, France
| | - Michele T Martin
- Commissariat ã l'Energie Atomique et aux Energies Alternatives, DRF, Francois Jacob Institute of Biology, Laboratory of Genomics and Radiobiology of Keratinopoiesis, Institute of Cellular and Molecular Radiobiology, Evry, France.,Université Paris-Saclay, Saint-Aubin, France
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