Insulin activates the hepatitis B virus X gene through the activating protein-1 binding site in HepG2 cells

Insulin stimulates cellular oncogenic activators such as c-jun, c-fos, and c-myc; and hepatitis B virus (HBV) X, a viral transactivator, is known to induce liver cancer in transgenic mice. In this respect, the effect of insulin on the expression of HBx protein was investigated in HepG2 cells. Insulin-stimulated transcription from the HBV X promoter in a dose-dependent manner was assessed by chloramphenicol acetyltransferase (CAT) assay. A mutation preventing AP-1 binding to the E element abolished the activation of the HBV X promoter by insulin. In addition, insulin stimulated the minimal thymidine kinase (tk) gene promoter activity through both the HBV E element and the consensus AP-1 binding site in HepG2 cells. An electrophoretic mobility shift assay (EMSA) using insulin-treated HepG2 nuclear extracts showed that insulin actually enhanced the binding of nuclear proteins to the HBV E element as well as to the consensus AP-1 binding site. Both HBV E and AP-1 oligonucleotides were effective competitors for this binding. These results showed that insulin elevated the expression of HBx protein through the AP-1 binding site of HBV EnI. We suggest that insulin can augment the role of HBx in the development of hepatocellular carcinoma (HCC) in HBV-infected liver, probably through interaction with other cellular oncogenes.