Abstract 2821: Joint relationship between iron and retinoids in patients at high-risk for liver cancer

Approximately 3.2 million Americans are chronically infected with Hepatitis C, forming the largest group of persons at high risk for HCC, with an annual incidence of 3-4%. Increased oxidative stress is regarded as the major mechanism of progression in chronic liver disease (CLD) and subsequent HCC. Hepatic iron overload facilitates the production of reactive oxygen species (ROS), thereby inducing liver damage and fibrosis. We have previously shown that retinoid and carotenoid depletion occurs early in disease and may represent a major modifiable risk. This study aims to determine, in CLD patients and controls, whether retinoid levels modify the association between serum iron concentrations and: (a) oxidative stress biomarkers in urine (b) tissue changes associated with hepatic stellate cell (HSC) activation, and (c) CLD progression. Patients with HCV undergoing liver biopsy (n = 69) provided fasting blood, fresh tissue, urine and completed a diet history questionnaire (DHQ). Serum and questionnaire data from healthy volunteers (n = 11), normal liver tissue from public repositories and patients without liver disease (n = 11) were also collected. Urinary isoprostanes, serum and tissue retinoid concentrations were obtained by LC-MS-MS. Serum iron, ferritin and transferrin were quantitated. Immunohistochemistry for αSMA was performed on FFPE sections and subsequently quantified via digital image analysis. Associations between urinary isoprostanes, αSMA levels, serum iron, serum and tissue retinoids were assessed using Spearman correlation coefficients and non-parametric tests were utilized to test differences among disease severity groups. There was a significant increasing trend for serum transferrin levels with progressive fibrosis, but not for serum iron and ferritin concentrations. All subjects had transferrin saturation within the normal range. Serum β-carotene and lycopene were inversely associated with serum ferritin concentrations (r = -0.29, P < 0.01; r = -0.29, P < 0.01) however, this relationship was not observed for other serum iron measurements. Serum iron measurements were not associated with hepatic retinoids/carotenoids, αSMA expression or urinary isoprostanes. Tissue retinyl palmitate was inversely and significantly correlated with hepatic αSMA expression (r = -0.3, P < 0.02). Serum iron overload was not evident in this population even though a depletion of serum retinoids/carotenoids is observed. The inverse correlation observed between serum