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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">IJMM</journal-id>
<journal-title>International Journal of Molecular Medicine</journal-title>
<issn pub-type="ppub">1107-3756</issn>
<issn pub-type="epub">1791-244X</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ijmm.2012.1096</article-id>
<article-id pub-id-type="publisher-id">ijmm-30-05-1021</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject></subj-group></article-categories>
<title-group>
<article-title>Curcumin inhibits HCV replication by induction of heme oxygenase-1 and suppression of AKT</article-title></title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>CHEN</surname><given-names>MING-HO</given-names></name><xref rid="af1-ijmm-30-05-1021" ref-type="aff"><sup>1</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>LEE</surname><given-names>MING-YANG</given-names></name><xref rid="af2-ijmm-30-05-1021" ref-type="aff"><sup>2</sup></xref><xref rid="af3-ijmm-30-05-1021" ref-type="aff"><sup>3</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>CHUANG</surname><given-names>JING-JING</given-names></name><xref rid="af4-ijmm-30-05-1021" ref-type="aff"><sup>4</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>LI</surname><given-names>YI-ZHEN</given-names></name><xref rid="af4-ijmm-30-05-1021" ref-type="aff"><sup>4</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>NING</surname><given-names>SIN-TZU</given-names></name><xref rid="af4-ijmm-30-05-1021" ref-type="aff"><sup>4</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>CHEN</surname><given-names>JUNG-CHOU</given-names></name><xref rid="af5-ijmm-30-05-1021" ref-type="aff"><sup>5</sup></xref><xref rid="af6-ijmm-30-05-1021" ref-type="aff"><sup>6</sup></xref></contrib>
<contrib contrib-type="author">
<name><surname>LIU</surname><given-names>YI-WEN</given-names></name><xref ref-type="corresp" rid="c1-ijmm-30-05-1021"/><xref rid="af4-ijmm-30-05-1021" ref-type="aff"><sup>4</sup></xref></contrib></contrib-group>
<aff id="af1-ijmm-30-05-1021">
<label>1</label>Departments of Chinese Medicine and</aff>
<aff id="af2-ijmm-30-05-1021">
<label>2</label>Hematology and Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi;</aff>
<aff id="af3-ijmm-30-05-1021">
<label>3</label>Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan;</aff>
<aff id="af4-ijmm-30-05-1021">
<label>4</label>Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi;</aff>
<aff id="af5-ijmm-30-05-1021">
<label>5</label>School of Post Baccalaureate Chinese Medicine, Chinese Medical University, Taichung;</aff>
<aff id="af6-ijmm-30-05-1021">
<label>6</label>The School of Chinese Medicine for Post-Baccalaureate, I-SHOU University, Kaohsiung, 
<country>Taiwan</country>, R.O.C.</aff>
<author-notes>
<corresp id="c1-ijmm-30-05-1021">Correspondence to: Dr Yi-Wen Liu, Department of Microbiology, Immunology and Biopharmaceuticals, College of Life Sciences, National Chiayi University, 300 Syuefu Rd., Chiayi 600, Taiwan, R.O.C., E-mail: <email>ywlss@mail.ncyu.edu.tw</email></corresp></author-notes>
<pub-date pub-type="collection">
<month>11</month>
<year>2012</year></pub-date>
<pub-date pub-type="ppub">
<month>11</month>
<year>2012</year></pub-date>
<pub-date pub-type="epub">
<day>20</day>
<month>08</month>
<year>2012</year></pub-date>
<volume>30</volume>
<issue>5</issue>
<fpage>1021</fpage>
<lpage>1028</lpage>
<history>
<date date-type="received">
<day>29</day>
<month>05</month>
<year>2012</year></date>
<date date-type="accepted">
<day>30</day>
<month>07</month>
<year>2012</year></date></history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2012, Spandidos Publications</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0">
<p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</p></license></permissions>
<abstract>
<p>Although hepatitis C virus (HCV) affects approximately 130&#x02013;170 million people worldwide, no vaccines are available. HCV is an important cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma, leading to the need for liver transplantation. In this study, curcumin, a constituent used in traditional Chinese medicine, has been evaluated for its anti-HCV activity and mechanism, using a human hepatoma cell line containing the HCV genotype 1b subgenomic replicon. Below the concentration of 20&#x00025; cytotoxicity, curcumin dose-dependently inhibited HCV replication by luciferase reporter gene assay, HCV RNA detection and HCV protein analysis. Under the same conditions, curcumin also dose-dependently induced heme oxygenase-1 with the highest induction at 24 h. Hemin, a heme oxygenase-1 inducer, also inhibited HCV protein expression in a dose-dependent manner. The knockdown of heme oxygenase-1 partially reversed the curcumin-inhibited HCV protein expression. In addition to the heme oxygenase-1 induction, signaling molecule activities of AKT, extracellular signal-regulated kinases (ERK) and nuclear factor-&#x003BA;B (NF-&#x003BA;B) were inhibited by curcumin. Using specific inhibitors of PI3K-AKT, MEK-ERK and NF-&#x003BA;B, the results suggested that only PI3K-AKT inhibition is positively involved in curcumin-inhibited HCV replication. Inhibition of ERK and NF-&#x003BA;B was likely to promote HCV protein expression. In summary, curcumin inhibited HCV replication by heme oxygenase-1 induction and AKT pathway inhibition. Although curcumin also inhibits ERK and NF-&#x003BA;B activities, it slightly increased the HCV protein expression. This result may provide information when curcumin is used as an adjuvant in anti-HCV therapy.</p></abstract>
<kwd-group>
<kwd>hepatitis C</kwd>
<kwd>curcumin</kwd>
<kwd>heme oxygenase-1</kwd>
<kwd>AKT</kwd>
<kwd>extracellular signal-regulated kinases</kwd>
<kwd>nuclear factor-&#x003BA;B</kwd></kwd-group></article-meta></front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Hepatitis C virus (HCV) affects approximately 130&#x02013;170 million people worldwide (<xref ref-type="bibr" rid="b1-ijmm-30-05-1021">1</xref>), however, no vaccines are available. It is an important cause of chronic hepatitis, cirrhosis, hepatocellular carcinoma (HCC), leading to a need for liver transplantation (<xref ref-type="bibr" rid="b2-ijmm-30-05-1021">2</xref>,<xref ref-type="bibr" rid="b3-ijmm-30-05-1021">3</xref>). Treatment of chronic HCV is currently based on the combination of pegylated interferon (IFN)-&#x003B1; and the nucleotide analogue ribavirin, which is only effective in approximately 50&#x00025; of the patients, especially in HCV genotype 1 (<xref ref-type="bibr" rid="b4-ijmm-30-05-1021">4</xref>,<xref ref-type="bibr" rid="b5-ijmm-30-05-1021">5</xref>). HCV belongs to the <italic>Hepacivirus</italic> genus within the <italic>Flaviviridae</italic> family, and is a positive-stranded RNA virus with a genome of &#x0223C;9.6 kb. The HCV genome contains a single open reading frame (ORF) encoding a large polyprotein precursor of 3011 amino acids. The ORF is flanked by 5&#x02032; and 3&#x02032; untranslated regions. The precursor polyprotein is processed by cellular and viral proteases into 10 proteins: structural (core, E1 and E2), and non-structural proteins (p7, NS2, NS3, NS4A, NS4B, NS5A and NS5B) (<xref ref-type="bibr" rid="b3-ijmm-30-05-1021">3</xref>,<xref ref-type="bibr" rid="b6-ijmm-30-05-1021">6</xref>). There are six major genotypes in HCV classification (<xref ref-type="bibr" rid="b3-ijmm-30-05-1021">3</xref>). The major prevalent type in Southern Taiwan is HCV 1b, which is the most resistant type to interferon therapy (<xref ref-type="bibr" rid="b5-ijmm-30-05-1021">5</xref>,<xref ref-type="bibr" rid="b7-ijmm-30-05-1021">7</xref>).</p>
<p>Curcumin, derived from eastern traditional medicines, <italic>Curcuma longa</italic>, has been found to have a variety of beneficial properties, such as anti-inflammatory, antioxidant, chemopreventive and chemotherapeutic activities (<xref ref-type="bibr" rid="b8-ijmm-30-05-1021">8</xref>,<xref ref-type="bibr" rid="b9-ijmm-30-05-1021">9</xref>). Its multiple-target characteristics influence several activities of intracellular molecules, including transcription nuclear factor-&#x003BA;B (NF-&#x003BA;B), pro-inflammatory cyclooxygenase-2 and MAPK inhibitions, as well as heme oxygenase-1 induction (<xref ref-type="bibr" rid="b9-ijmm-30-05-1021">9</xref>). In the antivirus bioactivity, certain reports have indicated that curcumin showed anti-viral activity against the human immunodeficiency (<xref ref-type="bibr" rid="b10-ijmm-30-05-1021">10</xref>,<xref ref-type="bibr" rid="b11-ijmm-30-05-1021">11</xref>), the coxsackie- (<xref ref-type="bibr" rid="b12-ijmm-30-05-1021">12</xref>) and the hepatitis B (HBV) viruses (<xref ref-type="bibr" rid="b13-ijmm-30-05-1021">13</xref>). In the anti-HCV study, one report showed that curcumin inhibited a lipogenic transcription factor, sterol regulatory element binding protein-1 (SREBP-1)-induced HCV replication via the inhibition of the PI3K-AKT pathway (<xref ref-type="bibr" rid="b14-ijmm-30-05-1021">14</xref>).</p>
<p>The catabolism of heme by heme oxygenase (HO) resulted in the production of biliverdin, carbon monoxide and free iron. HO-1, one of the phase II enzymes, is an enzyme in cells with cytoprotective properties against oxidative damage (<xref ref-type="bibr" rid="b15-ijmm-30-05-1021">15</xref>) that has been reported to be induced by the Nrf2 transcription factor (<xref ref-type="bibr" rid="b16-ijmm-30-05-1021">16</xref>). Curcumin-induced HO-1 expression was first found in human endothelial cells (<xref ref-type="bibr" rid="b17-ijmm-30-05-1021">17</xref>), suggesting that a low dose of curcumin induced HO-1 expression, which provided an intrinsic antioxidant ability. Curcumin also induced HO-1 expression in mesangial (<xref ref-type="bibr" rid="b18-ijmm-30-05-1021">18</xref>) and liver cells (<xref ref-type="bibr" rid="b19-ijmm-30-05-1021">19</xref>&#x02013;<xref ref-type="bibr" rid="b21-ijmm-30-05-1021">21</xref>), as well as in macrophages (<xref ref-type="bibr" rid="b22-ijmm-30-05-1021">22</xref>,<xref ref-type="bibr" rid="b23-ijmm-30-05-1021">23</xref>). The induction or overexpression of HO-1 has been shown to interfere with the replication of certain viruses, such as the human immunodeficiency virus (<xref ref-type="bibr" rid="b24-ijmm-30-05-1021">24</xref>), the HBV (<xref ref-type="bibr" rid="b25-ijmm-30-05-1021">25</xref>) and the HCV (<xref ref-type="bibr" rid="b26-ijmm-30-05-1021">26</xref>&#x02013;<xref ref-type="bibr" rid="b28-ijmm-30-05-1021">28</xref>).</p>
<p>The properties of the transcription factor NF-&#x003BA;B are extensively exploited in cells (<xref ref-type="bibr" rid="b29-ijmm-30-05-1021">29</xref>). In general, NF-&#x003BA;B is of great importance in signal transduction pathways involved in chronic and acute inflammatory diseases, as well as various types of cancer, therefore, it is a good target for cancer prevention (<xref ref-type="bibr" rid="b30-ijmm-30-05-1021">30</xref>). Various reports have demonstrated the correlation between curcumin and NF-&#x003BA;B. One of those reports suggests the anti-inflammatory effect of curcumin, which suppresses the ox-LDL-induced MCP-1 expression via the p38 MAPK and NF-&#x003BA;B pathways in rat vascular smooth muscle cells (<xref ref-type="bibr" rid="b31-ijmm-30-05-1021">31</xref>). The anti-inflammatory effect of curcumin has been reported to be due to the I&#x003BA;B/NF-&#x003BA;B system in rat and human intestinal epithelial cells, including IEC-6, HT-29 and Caco-2 cells (<xref ref-type="bibr" rid="b32-ijmm-30-05-1021">32</xref>). Curcumin has also been found to have anti-metastatic properties via the inhibition of NF-&#x003BA;B in the highly invasive and metastatic MDA-MB-231 breast cancer cell line (<xref ref-type="bibr" rid="b33-ijmm-30-05-1021">33</xref>). Another signaling pathway, Raf/MEK/extracellular signal-regulated kinases (ERK), is of crucial importance in the regulation of cell growth, differentiation, survival, as well as the transmission of oncogenic signals (<xref ref-type="bibr" rid="b34-ijmm-30-05-1021">34</xref>). This pathway has also been reported to be a target of curcumin. For example, curcumin inhibited connective tissue growth factor gene expression by suppressing ERK signaling in activated hepatic stellate cells (<xref ref-type="bibr" rid="b35-ijmm-30-05-1021">35</xref>). Moreover, curcumin inhibited phorbol myristate acetate-induced MCP-1 gene expression by inhibiting ERK and NF-&#x003BA;B activities in U937 cells (<xref ref-type="bibr" rid="b36-ijmm-30-05-1021">36</xref>). However, the manner in which curcumin affects the activities of NF-&#x003BA;B and ERK in HCV-infected hepatoma cells has yet to be determine.</p>
<p>Only one study suggesting that curcumin inhibited HCV replication by suppressing the AKT-SREBP-1 pathway is currently available (<xref ref-type="bibr" rid="b14-ijmm-30-05-1021">14</xref>). In this study, the correlation between curcumin-inhibited HCV replication, HO-1, AKT, ERK and NF-&#x003BA;B molecules was examined.</p></sec>
<sec sec-type="methods">
<title>Materials and methods</title>
<sec>
<title>Cell culture and reagents</title>
<p>Huh7.5 cells expressing the HCV genotype 1b subgenomic replicon (Con1/SG-Neo(I) hRlucFMDV2aUb) containing <italic>Renilla</italic> luciferase reporter, kindly provided by Apath, were cultured in Dulbecco&#x02019;s Modified Eagle&#x02019;s Medium (DMEM) with 10&#x00025; fetal bovine serum (FBS), 100 U/ml penicillin, 100 mg/ml streptomycin and 0.5 mg/ml G418. The nuclear extraction kit was purchased from Chemicon (Temecula, CA, USA). Curcumin (Acros Organics, Geel, Belgium), LY294002, U0126 and Ro1069920 were purchased from Tocris (Bristol, UK), and dissolved in dimethyl sulfoxide (DMSO), then added into culture medium containing 0.1&#x00025; DMSO.</p></sec>
<sec>
<title>Cell viability assay</title>
<p>Cell viability was determined by colorimetric MTT assay. Cells were cultured on 24-well plates at a density of 1&#x000D7;10<sup>5</sup> cells/well. After 24 h, the cells were incubated with varying concentrations of curcumin or 0.1&#x00025; DMSO for another 24 h. MTT was added to medium for 2 h, the medium was discarded and DMSO was then added to dissolve the formazan product. Each well was measured by light absorbance at 490 nm. The result was expressed as a percentage, relative to the 0.1&#x00025; DMSO-treated control group.</p></sec>
<sec>
<title>Luciferase reporter assay</title>
<p>Cells were subcultured at a density of 4&#x000D7;10<sup>5</sup> cells/well in 1 ml of culture medium in a 12-well plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. The cells were lysed and cell lysates were prepared for a <italic>Renilla</italic> luciferase assay (Promega, Madison, WI, USA) and protein concentration assays, with Bio-Rad protein assay (Bio-Rad, Hercules, CA, USA). The relative luciferase activities were normalized to the same protein concentration.</p></sec>
<sec>
<title>Real-time RT-PCR analysis</title>
<p>Total RNA was isolated from Huh7.5 cells expressing the HCV genotype 1b subgenomic replicon. Reverse transcription (RT) was performed on 2 &#x003BC;g of total RNA by 1.5 &#x003BC;M random hexamer and RevertAid&#x02122; reverse transcriptase (Fermentas, Glen Burnie, MD, USA). Then, 1/20 volume of reaction mixture was used for quantitative real-time PCR with HCV specific primers: 5&#x02032;-AGCGTCTAGCCATGGCGT-3&#x02032; and 5&#x02032;-GGTGTACTCACCGGTTCCG-3&#x02032;, and GAPDH specific primers: 5&#x02032;-CGGATTTGGTCGTATTGG-3&#x02032; and 5&#x02032;-AGATGGT GATGGGATTTC-3&#x02032;, as the endogenous control. The quantitative real-time PCR was followed by Maxima&#x02122; SYBR-Green qPCR Master Mix (Fermentas). Real-time PCR reactions contained optimal volume of the reverse transcription mixture, 600 nM each forward and reverse primer and 1X SYBR-Green qPCR Master Mix in 25 &#x003BC;l. Reactions were incubated for 40 cycles in an ABI GeneAmp<sup>&#x000AE;</sup> 7500 Sequence Detection System, with an initial denaturization step at 95&#x000B0;C for 10 min, followed by 40 cycles of 95&#x000B0;C for 15 sec and 63&#x000B0;C for 1 min. PCR product accumulation was monitored at several points during each cycle, by measuring the increase in fluorescence. Gene expression changes were assessed using the comparative Ct method. The relative amounts of mRNA for HCV were optimized by subtracting the Ct values of HCV from the Ct values of GAPDH mRNA (&#x00394;Ct). The &#x00394;Ct of the control group was then subtracted from the &#x00394;Ct of the curcumin-treated groups (&#x00394;&#x00394;Ct). Data were expressed as relative levels of HCV RNA.</p></sec>
<sec>
<title>Western blotting</title>
<p>For western blotting, analytical 10&#x00025; sodium dodecyl sulfate (SDS)-polyacrylamide slab gel electrophoresis was performed. Tissue extracts were prepared and a 30&#x02013;60 &#x003BC;g aliquot of protein extracts was analyzed. For immunoblotting, proteins in the SDS-PAGE gels were transferred to a polyvinylidene difluoride membrane using a trans-blot apparatus. Antibodies against HCV NS5A and HCV NA5B (Santa Cruz Biotechnology, Inc., Santa Cruz, CA, USA), HO-1 (Assay Designs, Inc., Ann Arbor, MI, USA), pAKT (308) and pERK (Santa Cruz Biotechnology, Inc.), NF-&#x003BA;B (Cell Signaling Technology, Beverly, MA, USA), Sp1 (Millipore, Darmstadt, Germany), &#x003B1;-tubulin (GeneTex, Inc., Irvine, CA, USA) and &#x003B2;-actin (Sigma-Aldrich, St. Louis, MO, USA) were used as the primary antibodies. Mouse, rabbit or goat IgG antibodies coupled with horseradish peroxidase were used as the secondary antibodies. An enhanced chemiluminescence kit and VL Chemi-Smart 3000 were used for detection, while the quantity of each band was determined using MultiGauge software.</p></sec>
<sec>
<title>HO-1 knockdown by siRNA</title>
<p>Cells (3&#x000D7;10<sup>6</sup>) were seeded in 10-cm dishes for 6 h, then negative control small interfering (siRNA) (10 nM) or HO-1 siRNA (10 nM) (Invitrogen) was transfected into cells using the RNAiMAX Transfection Reagent (Invitrogen), according to the manufacturer&#x02019;s instructions. Subsequent to adding siRNA for 6 h, the medium was changed to fresh condition medium for 18 h. Then the transfected cells were then analyzed by western blotting.</p></sec>
<sec>
<title>Statistical analysis</title>
<p>Data were expressed as the mean &#x000B1; SE. Statistical evaluation was carried out by one-way ANOVA followed by Dunn&#x02019;s test. All statistics were calculated using SigmaStat version 3.5 (Systat Software). P&#x0003C;0.05 was considered to indicate a statistically significant difference.</p></sec></sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title>Cytotoxicity of curcumin in Huh7.5 cells expressing the HCV genotype 1b subgenomic replicon (Huh7.5-HCV cells)</title>
<p>Curcumin is known to be an anticancer chemical at high doses. To avoid the obvious cytotocicity in the subsequent experiments, the MTT assay was applied for cytotoxicity analysis. The results show that curcumin dose-dependently decreased cell viability (<xref rid="f1-ijmm-30-05-1021" ref-type="fig">Fig. 1</xref>). The dose &#x0003C;20 &#x003BC;M was selected for subsequent analysis, given that the viability of 25 &#x003BC;M curcumin treatment is &#x0003C;80&#x00025;.</p></sec>
<sec>
<title>Curcumin reduced HCV replication and HCV protein expression</title>
<p>Due to the presence of a luciferase reporter gene in the HCV subgenomic replicon of Con1/SG-Neo(I)hRlucFMDV2aUb, the culture medium luciferase activity was first analyzed subsequent to curcumin treatment. The results show that curcumin dose-dependently inhibited luciferase activity (<xref rid="f2-ijmm-30-05-1021" ref-type="fig">Fig. 2A</xref>). However, the HCV RNA was also detected by real-time PCR. Curcumin also reduced the intracellular HCV RNA expression in a dose-dependent manner. Subsequent to curcumin treatment the HCV-specific protein NS5A and NS5B were detected by western blot analysis, indicating that curcumin dose-dependently inhibited expression of the NS5A and NS5B. The above data suggest that curcumin inhibited HCV replication in hepatoma cells.</p></sec>
<sec>
<title>Curcumin induced HO-1 protein expression</title>
<p>Curcumin is known to induce HO-1 expression in various cells. This effect was analyzed in Huh7.5-HCV cells. Curcumin slightly induced HO-1 expression in a 6-h treatment, while significantly inducing it in 12 and 24 h. The HO-1 induction declined after treatment for 48 h (<xref rid="f3-ijmm-30-05-1021" ref-type="fig">Fig. 3A</xref>). Curcumin also induced HO-1 expression in a dose-dependent manner (<xref rid="f3-ijmm-30-05-1021" ref-type="fig">Fig. 3B</xref>). The change of NS5A, NS5B and HO-1 protein expressions was simultaneously detected by western blot analysis, indicating that curcumin dose-dependently inhibited the expression of NS5A and NS5B, while increasing the HO-1 expression (<xref rid="f3-ijmm-30-05-1021" ref-type="fig">Fig. 3C</xref>).</p></sec>
<sec>
<title>Hemin reduced HCV replication and the HCV protein expression</title>
<p>The HO-1 inducer hemin was used to analyze its effect on HCV replication as well as on the protein expression of HCV NS5A and NS5B. The result showed that hemin dose-dependently decreased HCV replication (<xref rid="f4-ijmm-30-05-1021" ref-type="fig">Fig. 4A</xref>). Furthermore, curcumin inhibited the protein expression of NS5A and NS5B, while enhancing the HO-1 protein expression. This finding suggested that HO-1 protein inhibited HCV replication in Huh7.5-HCV cells (<xref rid="f4-ijmm-30-05-1021" ref-type="fig">Fig. 4</xref>).</p></sec>
<sec>
<title>HO-1 knockdown partially reversed the curcumin-reduced viral protein expression</title>
<p>In order to prove the direct relationship between curcumin-induced HO-1 and curcumin-inhibited HCV replication, the HO-1 specific siRNA was used for analysis. HO-1 siRNA significantly inhibited basal and curcumin-induced HO-1 expression (<xref rid="f5-ijmm-30-05-1021" ref-type="fig">Fig. 5A</xref>). HO-1 knockdown slightly increased the NS5A and NS5B protein expressions in the basal condition. At the same time, it partially but significantly reversed the curcumin-inhibited the expression of NS5A and NS5B, suggesting that curcumin-induced HO-1 was involved in curcumin-inhibited HCV replication, while having additional mechanisms regarding the anti-HCV effect of curcumin.</p></sec>
<sec>
<title>Effect of the PI3K-AKT, MEK-ERK and NF-&#x003BA;B pathways on curcumin-inhibited HCV replication</title>
<p><xref rid="f5-ijmm-30-05-1021" ref-type="fig">Fig. 5A</xref> shows that HO-1 is partially involved in curcumin-inhibited HCV replication. Additional signaling pathways affected by curcumin were analyzed, demonstrating that curcumin inhibited the protein phosphorylation of ERK and AKT, as well as the cytoplasmic protein expression of NF-&#x003BA;B (<xref rid="f5-ijmm-30-05-1021" ref-type="fig">Fig. 5B</xref>). Therefore, the specific inhibitors of PI3K-AKT (LY294002), MEK-ERK (U0126) and NF-&#x003BA;B (Ro 106-9920) were used to identify the role of AKT, ERK and NF-&#x003BA;B in the HCV protein expression. <xref rid="f5-ijmm-30-05-1021" ref-type="fig">Fig. 5C</xref> shows that curcumin was the only chemical to induce the HO-1 expression. Of the three inhibitors, only PI3K-AKT LY294002 slightly inhibited the HCV protein expression, while MEK-ERK U0126 and NF-&#x003BA;B inhibitors Ro 1069920 had a slight effect on increasing the HCV protein expression, suggesting that curcumin-inhibited HCV replication was also partially mediated via PI3K-AKT inhibition.</p></sec></sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Curcumin is a common chemical ingredient of curry. It has, however, been studied in clinical trials regarding its applicability in treating patients suffering from pancreatic and colon cancer, as well as multiple myeloma (<xref ref-type="bibr" rid="b37-ijmm-30-05-1021">37</xref>). In Taiwan, several doctors of traditional Chinese medicine consider curcumin to be beneficial for patients suffering from hepatitis. The results of this study demonstrate that curcumin inhibits HCV replication in cellular analysis, and its mechanism partially occurs through HO-1 induction and PI3K-AKT inhibition.</p>
<p>HO-1, a curcumin-induced gene, is thought to be a potential therapeutic protein for the re-establishment of homeostasis in several pathologic conditions (<xref ref-type="bibr" rid="b38-ijmm-30-05-1021">38</xref>) and is also involved in inhibiting HCV replication (<xref ref-type="bibr" rid="b28-ijmm-30-05-1021">28</xref>). The HO-1 products biliverdin and iron contribute to certain anti-HCV mechanisms of HO-1 (<xref ref-type="bibr" rid="b26-ijmm-30-05-1021">26</xref>,<xref ref-type="bibr" rid="b39-ijmm-30-05-1021">39</xref>,<xref ref-type="bibr" rid="b40-ijmm-30-05-1021">40</xref>). In this study, HO-1 knockdown partially reversed curcumin-inhibited HCV replication, supporting the evidence for the anti-HCV effect of HO-1. Since HO-1 is induced by ROS or certain electrophiles, ROS has also been reported to inhibit HCV replication (<xref ref-type="bibr" rid="b41-ijmm-30-05-1021">41</xref>,<xref ref-type="bibr" rid="b42-ijmm-30-05-1021">42</xref>). Arsenic trioxide-inhibited HCV replication is also suggested to be mediated through the induction of oxidative stress (<xref ref-type="bibr" rid="b43-ijmm-30-05-1021">43</xref>). HO-1, an oxidative stress-induced gene, may be involved in the ROS-inhibited HCV replication.</p>
<p>As a downstream kinase of PI3K, AKT is an important molecule in regulating a wide range of signaling pathways (<xref ref-type="bibr" rid="b44-ijmm-30-05-1021">44</xref>). In HCV-infected cells, the PI3K-AKT signaling pathway is involved in certain pathological mechanisms. For example, the activities of PI3K, AKT and their downstream target mTOR are increased in the HCV-replicating cells (<xref ref-type="bibr" rid="b45-ijmm-30-05-1021">45</xref>). HCV NS5A binds to PI3K, while enhancing the phosphotransferase activity of the catalytic domain (<xref ref-type="bibr" rid="b46-ijmm-30-05-1021">46</xref>). The HCV-activated PI3K-AKT contributes to cell survival enhancement. In addition to cell survival, AKT leads to the protein accumulation of SREBP-1, an important transcription factor regulating genes involved in fatty acid and cholesterol synthesis (<xref ref-type="bibr" rid="b47-ijmm-30-05-1021">47</xref>). HCV NS4B has been found to enhance the protein expression levels of SREBPs and fatty acid synthase through PI3K activity, subsequently inducing a lipid accumulation in hepatoma cells (<xref ref-type="bibr" rid="b48-ijmm-30-05-1021">48</xref>). Therefore, inhibition of the PI3K-SREBP signaling pathway should decrease the HCV-induced HCC development and the cellular fatty acid level. Curcumin has been reported to inhibit HCV replication via suppression of the AKT-SREBP-1 pathway (<xref ref-type="bibr" rid="b14-ijmm-30-05-1021">14</xref>). In the present study, data also demonstrated that curcumin-inhibited PI3K-AKT was slightly involved in the anti-HCV activity of curcumin.</p>
<p>Activation of the MEK-ERK signal cascade enhances the replication of viruses, such as the human immunodeficiency (<xref ref-type="bibr" rid="b49-ijmm-30-05-1021">49</xref>), the influenza (<xref ref-type="bibr" rid="b50-ijmm-30-05-1021">50</xref>), the corona- (<xref ref-type="bibr" rid="b51-ijmm-30-05-1021">51</xref>) and the herpes simplex viruses (<xref ref-type="bibr" rid="b52-ijmm-30-05-1021">52</xref>). By contrast, in the case of HBV, activation of MEK-ERK signaling led to the inhibition of HBV replication (<xref ref-type="bibr" rid="b53-ijmm-30-05-1021">53</xref>). In the HCV study, interleukin-1 has been reported to have the potential to effectively inhibit HCV replication and protein expression by activating the ERK signaling pathway (<xref ref-type="bibr" rid="b54-ijmm-30-05-1021">54</xref>). HCV IRES-dependent protein synthesis was enhanced by MEK-ERK inhibitor PD98059 (<xref ref-type="bibr" rid="b55-ijmm-30-05-1021">55</xref>). Another report also suggests that inhibition of MEK-ERK signaling leads to the upregulation of HCV replication and protein production (<xref ref-type="bibr" rid="b56-ijmm-30-05-1021">56</xref>). Consistent with the results of the present study, those findings confirm that the curcumin-inhibited MEK-ERK signaling pathway contributes to the increase of HCV replication.</p>
<p>NF-&#x003BA;B, one of the major signaling transduction molecules activated in response to oxidative stress, is able to modulate the transcription of a large number of downstream genes. The HCV core protein has been shown to activate NF-&#x003BA;B, inducing resistance to TNF-&#x003B1;-induced apoptosis in hepatoma cells (<xref ref-type="bibr" rid="b57-ijmm-30-05-1021">57</xref>). HCV NS2 activates the IL-8 gene expression by activating the NF-&#x003BA;B pathway in HepG2 cells (<xref ref-type="bibr" rid="b58-ijmm-30-05-1021">58</xref>). In the infectious JFH1 model, HCV is suggested to enhance hepatic fibrosis progression through the induction of TGF-&#x003B2;1, mediated by a ROS-induced and NF-&#x003BA;B-dependent pathway (<xref ref-type="bibr" rid="b59-ijmm-30-05-1021">59</xref>). These evidences indicate that the activation of NF-&#x003BA;B by HCV induces hepatic disease progression. In this study, the NF-&#x003BA;B expression is abundant in the cytoplasm of Huh7.5 cells, expressing the HCV genotype 1b subgenomic replicon (<xref rid="f5-ijmm-30-05-1021" ref-type="fig">Fig. 5B</xref>). The absence of NF-&#x003BA;B nuclear translocation indicates that NF-&#x003BA;B is not likely to participate in the mechanism of hepatocarcinogenesis in this cell line. The absense of complete HCV core and HCV NS2 sequences in the subgenomic replicon used in this study, is likely to be the reason for the absence of NF-&#x003BA;B nuclear translocation. Therefore, it is likely to contribute to the inability of the NF-&#x003BA;B inhibitor to suppress the HCV protein expression in this cell line. In fact, the genomic variation of HCV core protein generates a distinct functional regulation of NF-&#x003BA;B, which may inhibit or activate NF-&#x003BA;B activity (<xref ref-type="bibr" rid="b60-ijmm-30-05-1021">60</xref>).</p>
<p>In certain reports, the inhibition of NF-&#x003BA;B shows anti-HCV activity: for example, the <italic>Acacia confusa</italic> (<xref ref-type="bibr" rid="b61-ijmm-30-05-1021">61</xref>) and San-Huang-Xie-Xin-Tang extracts (<xref ref-type="bibr" rid="b62-ijmm-30-05-1021">62</xref>) suppress HCV replication associated with NF-&#x003BA;B inhibition. In the present study, curcumin-inhibited NF-&#x003BA;B does not have any benefit in anti-HCV activity. Thus, the presence or absence of the inhibition of NF-&#x003BA;B in anti-HCV therapy is likely to depend on the activation status of NF-&#x003BA;B, although additional investigations are required on the subject.</p>
<p>In conclusion, this study proved that curcumin inhibits HCV replication through the induction of the HO-1 expression and the inhibition of the PI3K-AKT signaling pathway. However, the curcumin-inhibited MEK-ERK mechanism contributes negatively to its anti-HCV activity.</p></sec></body>
<back>
<ack>
<p>This study was financed by grants from the National Science Council (NSC98-2320-B-415-002-MY3) and from the Chiayi Christian Hospital, Taiwan.</p></ack>
<ref-list>
<title>References</title>
<ref id="b1-ijmm-30-05-1021"><label>1.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lavanchy</surname><given-names>D</given-names></name></person-group><article-title>The global burden of hepatitis C</article-title><source>Liver Int</source><volume>29</volume><issue>Suppl 1</issue><fpage>S74</fpage><lpage>S81</lpage><year>2009</year></citation></ref>
<ref id="b2-ijmm-30-05-1021"><label>2.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bostan</surname><given-names>N</given-names></name><name><surname>Mahmood</surname><given-names>T</given-names></name></person-group><article-title>An overview about hepatitis C: a devastating virus</article-title><source>Crit Rev Microbiol</source><volume>36</volume><fpage>91</fpage><lpage>133</lpage><year>2010</year></citation></ref>
<ref id="b3-ijmm-30-05-1021"><label>3.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Moradpour</surname><given-names>D</given-names></name><name><surname>Penin</surname><given-names>F</given-names></name><name><surname>Rice</surname><given-names>CM</given-names></name></person-group><article-title>Replication of hepatitis C virus</article-title><source>Nat Rev Microbiol</source><volume>5</volume><fpage>453</fpage><lpage>463</lpage><year>2007</year></citation></ref>
<ref id="b4-ijmm-30-05-1021"><label>4.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Feld</surname><given-names>JJ</given-names></name><name><surname>Hoofnagle</surname><given-names>JH</given-names></name></person-group><article-title>Mechanism of action of interferon and ribavirin in treatment of hepatitis C</article-title><source>Nature</source><volume>436</volume><fpage>967</fpage><lpage>972</lpage><year>2005</year></citation></ref>
<ref id="b5-ijmm-30-05-1021"><label>5.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Munir</surname><given-names>S</given-names></name><name><surname>Saleem</surname><given-names>S</given-names></name><name><surname>Idrees</surname><given-names>M</given-names></name><etal/></person-group><article-title>Hepatitis C treatment: current and future perspectives</article-title><source>Virol J</source><volume>7</volume><fpage>296</fpage><year>2010</year></citation></ref>
<ref id="b6-ijmm-30-05-1021"><label>6.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lindenbach</surname><given-names>BD</given-names></name><name><surname>Rice</surname><given-names>CM</given-names></name></person-group><article-title>Unravelling hepatitis C virus replication from genome to function</article-title><source>Nature</source><volume>436</volume><fpage>933</fpage><lpage>938</lpage><year>2005</year></citation></ref>
<ref id="b7-ijmm-30-05-1021"><label>7.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>CM</given-names></name><name><surname>Hung</surname><given-names>CH</given-names></name><name><surname>Lu</surname><given-names>SN</given-names></name><etal/></person-group><article-title>Viral etiology of hepatocellular carcinoma and HCV genotypes in Taiwan</article-title><source>Intervirology</source><volume>49</volume><fpage>76</fpage><lpage>81</lpage><year>2006</year></citation></ref>
<ref id="b8-ijmm-30-05-1021"><label>8.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hatcher</surname><given-names>H</given-names></name><name><surname>Planalp</surname><given-names>R</given-names></name><name><surname>Cho</surname><given-names>J</given-names></name><name><surname>Torti</surname><given-names>FM</given-names></name><name><surname>Torti</surname><given-names>SV</given-names></name></person-group><article-title>Curcumin: from ancient medicine to current clinical trials</article-title><source>Cell Mol Life Sci</source><volume>65</volume><fpage>1631</fpage><lpage>1652</lpage><year>2008</year></citation></ref>
<ref id="b9-ijmm-30-05-1021"><label>9.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Goel</surname><given-names>A</given-names></name><name><surname>Kunnumakkara</surname><given-names>AB</given-names></name><name><surname>Aggarwal</surname><given-names>BB</given-names></name></person-group><article-title>Curcumin as &#x02018;Curecumin&#x02019;: from kitchen to clinic</article-title><source>Biochem Pharmacol</source><volume>75</volume><fpage>787</fpage><lpage>809</lpage><year>2008</year></citation></ref>
<ref id="b10-ijmm-30-05-1021"><label>10.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Li</surname><given-names>CJ</given-names></name><name><surname>Zhang</surname><given-names>LJ</given-names></name><name><surname>Dezube</surname><given-names>BJ</given-names></name><name><surname>Crumpacker</surname><given-names>CS</given-names></name><name><surname>Pardee</surname><given-names>AB</given-names></name></person-group><article-title>Three inhibitors of type 1 human immunodeficiency virus long terminal repeat-directed gene expression and virus replication</article-title><source>Proc Natl Acad Sci USA</source><volume>90</volume><fpage>1839</fpage><lpage>1842</lpage><year>1993</year></citation></ref>
<ref id="b11-ijmm-30-05-1021"><label>11.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mazumder</surname><given-names>A</given-names></name><name><surname>Raghavan</surname><given-names>K</given-names></name><name><surname>Weinstein</surname><given-names>J</given-names></name><name><surname>Kohn</surname><given-names>KW</given-names></name><name><surname>Pommier</surname><given-names>Y</given-names></name></person-group><article-title>Inhibition of human immunodeficiency virus type-1 integrase by curcumin</article-title><source>Biochem Pharmacol</source><volume>49</volume><fpage>1165</fpage><lpage>1170</lpage><year>1995</year></citation></ref>
<ref id="b12-ijmm-30-05-1021"><label>12.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Si</surname><given-names>X</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Wong</surname><given-names>J</given-names></name><name><surname>Zhang</surname><given-names>J</given-names></name><name><surname>McManus</surname><given-names>BM</given-names></name><name><surname>Luo</surname><given-names>H</given-names></name></person-group><article-title>Dysregulation of the ubiquitin-proteasome system by curcumin suppresses coxsackievirus B3 replication</article-title><source>J Virol</source><volume>81</volume><fpage>3142</fpage><lpage>3150</lpage><year>2007</year></citation></ref>
<ref id="b13-ijmm-30-05-1021"><label>13.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rechtman</surname><given-names>MM</given-names></name><name><surname>Har-Noy</surname><given-names>O</given-names></name><name><surname>Bar-Yishay</surname><given-names>I</given-names></name><etal/></person-group><article-title>Curcumin inhibits hepatitis B virus via down-regulation of the metabolic coactivator PGC-1alpha</article-title><source>FEBS Lett</source><volume>584</volume><fpage>2485</fpage><lpage>2490</lpage><year>2010</year></citation></ref>
<ref id="b14-ijmm-30-05-1021"><label>14.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname><given-names>K</given-names></name><name><surname>Kim</surname><given-names>KH</given-names></name><name><surname>Kim</surname><given-names>HY</given-names></name><name><surname>Cho</surname><given-names>HK</given-names></name><name><surname>Sakamoto</surname><given-names>N</given-names></name><name><surname>Cheong</surname><given-names>J</given-names></name></person-group><article-title>Curcumin inhibits hepatitis C virus replication via suppressing the Akt-SREBP-1 pathway</article-title><source>FEBS Lett</source><volume>584</volume><fpage>707</fpage><lpage>712</lpage><year>2010</year></citation></ref>
<ref id="b15-ijmm-30-05-1021"><label>15.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Otterbein</surname><given-names>LE</given-names></name><name><surname>Soares</surname><given-names>MP</given-names></name><name><surname>Yamashita</surname><given-names>K</given-names></name><name><surname>Bach</surname><given-names>FH</given-names></name></person-group><article-title>Heme oxygenase-1: unleashing the protective properties of heme</article-title><source>Trends Immunol</source><volume>24</volume><fpage>449</fpage><lpage>455</lpage><year>2003</year></citation></ref>
<ref id="b16-ijmm-30-05-1021"><label>16.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Khor</surname><given-names>TO</given-names></name><name><surname>Huang</surname><given-names>MT</given-names></name><name><surname>Kwon</surname><given-names>KH</given-names></name><name><surname>Chan</surname><given-names>JY</given-names></name><name><surname>Reddy</surname><given-names>BS</given-names></name><name><surname>Kong</surname><given-names>AN</given-names></name></person-group><article-title>Nrf2-deficient mice have an increased susceptibility to dextran sulfate sodium-induced colitis</article-title><source>Cancer Res</source><volume>66</volume><fpage>11580</fpage><lpage>11584</lpage><year>2006</year></citation></ref>
<ref id="b17-ijmm-30-05-1021"><label>17.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Motterlini</surname><given-names>R</given-names></name><name><surname>Foresti</surname><given-names>R</given-names></name><name><surname>Bassi</surname><given-names>R</given-names></name><name><surname>Green</surname><given-names>CJ</given-names></name></person-group><article-title>Curcumin, anti-oxidant and anti-inflammatory agent, induces heme oxygenase-1 and protects endothelial cells against oxidative stress</article-title><source>Free Radic Biol Med</source><volume>28</volume><fpage>1303</fpage><lpage>1312</lpage><year>2000</year></citation></ref>
<ref id="b18-ijmm-30-05-1021"><label>18.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gaedeke</surname><given-names>J</given-names></name><name><surname>Noble</surname><given-names>NA</given-names></name><name><surname>Border</surname><given-names>WA</given-names></name></person-group><article-title>Curcumin blocks fibrosis in anti-Thy 1 glomerulonephritis through up-regulation of heme oxygenase 1</article-title><source>Kidney Int</source><volume>68</volume><fpage>2042</fpage><lpage>2049</lpage><year>2005</year></citation></ref>
<ref id="b19-ijmm-30-05-1021"><label>19.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>McNally</surname><given-names>SJ</given-names></name><name><surname>Harrison</surname><given-names>EM</given-names></name><name><surname>Ross</surname><given-names>JA</given-names></name><name><surname>Garden</surname><given-names>OJ</given-names></name><name><surname>Wigmore</surname><given-names>SJ</given-names></name></person-group><article-title>Curcumin induces heme oxygenase-1 in hepatocytes and is protective in simulated cold preservation and warm reperfusion injury</article-title><source>Transplantation</source><volume>81</volume><fpage>623</fpage><lpage>626</lpage><year>2006</year></citation></ref>
<ref id="b20-ijmm-30-05-1021"><label>20.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bao</surname><given-names>W</given-names></name><name><surname>Li</surname><given-names>K</given-names></name><name><surname>Rong</surname><given-names>S</given-names></name><etal/></person-group><article-title>Curcumin alleviates ethanol-induced hepatocytes oxidative damage involving heme oxygenase-1 induction</article-title><source>J Ethnopharmacol</source><volume>128</volume><fpage>549</fpage><lpage>553</lpage><year>2010</year></citation></ref>
<ref id="b21-ijmm-30-05-1021"><label>21.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Farombi</surname><given-names>EO</given-names></name><name><surname>Shrotriya</surname><given-names>S</given-names></name><name><surname>Na</surname><given-names>HK</given-names></name><name><surname>Kim</surname><given-names>SH</given-names></name><name><surname>Surh</surname><given-names>YJ</given-names></name></person-group><article-title>Curcumin attenuates dimethylnitrosamine-induced liver injury in rats through Nrf2-mediated induction of heme oxygenase-1</article-title><source>Food Chem Toxicol</source><volume>46</volume><fpage>1279</fpage><lpage>1287</lpage><year>2008</year></citation></ref>
<ref id="b22-ijmm-30-05-1021"><label>22.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kim</surname><given-names>KM</given-names></name><name><surname>Pae</surname><given-names>HO</given-names></name><name><surname>Zhung</surname><given-names>M</given-names></name><etal/></person-group><article-title>Involvement of anti-inflammatory heme oxygenase-1 in the inhibitory effect of curcumin on the expression of pro-inflammatory inducible nitric oxide synthase in RAW264.7 macrophages</article-title><source>Biomed Pharmacother</source><volume>62</volume><fpage>630</fpage><lpage>636</lpage><year>2008</year></citation></ref>
<ref id="b23-ijmm-30-05-1021"><label>23.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hsu</surname><given-names>HY</given-names></name><name><surname>Chu</surname><given-names>LC</given-names></name><name><surname>Hua</surname><given-names>KF</given-names></name><name><surname>Chao</surname><given-names>LK</given-names></name></person-group><article-title>Heme oxygenase-1 mediates the anti-inflammatory effect of Curcumin within LPS-stimulated human monocytes</article-title><source>J Cell Physiol</source><volume>215</volume><fpage>603</fpage><lpage>612</lpage><year>2008</year></citation></ref>
<ref id="b24-ijmm-30-05-1021"><label>24.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Devadas</surname><given-names>K</given-names></name><name><surname>Dhawan</surname><given-names>S</given-names></name></person-group><article-title>Hemin activation ameliorates HIV-1 infection via heme oxygenase-1 induction</article-title><source>J Immunol</source><volume>176</volume><fpage>4252</fpage><lpage>4257</lpage><year>2006</year></citation></ref>
<ref id="b25-ijmm-30-05-1021"><label>25.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Protzer</surname><given-names>U</given-names></name><name><surname>Seyfried</surname><given-names>S</given-names></name><name><surname>Quasdorff</surname><given-names>M</given-names></name><etal/></person-group><article-title>Antiviral activity and hepatoprotection by heme oxygenase-1 in hepatitis B virus infection</article-title><source>Gastroenterology</source><volume>133</volume><fpage>1156</fpage><lpage>1165</lpage><year>2007</year></citation></ref>
<ref id="b26-ijmm-30-05-1021"><label>26.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lehmann</surname><given-names>E</given-names></name><name><surname>El-Tantawy</surname><given-names>WH</given-names></name><name><surname>Ocker</surname><given-names>M</given-names></name><etal/></person-group><article-title>The heme oxygenase 1 product biliverdin interferes with hepatitis C virus replication by increasing antiviral interferon response</article-title><source>Hepatology</source><volume>51</volume><fpage>398</fpage><lpage>404</lpage><year>2010</year></citation></ref>
<ref id="b27-ijmm-30-05-1021"><label>27.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Shan</surname><given-names>Y</given-names></name><name><surname>Zheng</surname><given-names>J</given-names></name><name><surname>Lambrecht</surname><given-names>RW</given-names></name><name><surname>Bonkovsky</surname><given-names>HL</given-names></name></person-group><article-title>Reciprocal effects of micro-RNA-122 on expression of heme oxygenase-1 and hepatitis C virus genes in human hepatocytes</article-title><source>Gastroenterology</source><volume>133</volume><fpage>1166</fpage><lpage>1174</lpage><year>2007</year></citation></ref>
<ref id="b28-ijmm-30-05-1021"><label>28.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhu</surname><given-names>Z</given-names></name><name><surname>Wilson</surname><given-names>AT</given-names></name><name><surname>Mathahs</surname><given-names>MM</given-names></name><etal/></person-group><article-title>Heme oxygenase-1 suppresses hepatitis C virus replication and increases resistance of hepatocytes to oxidant injury</article-title><source>Hepatology</source><volume>48</volume><fpage>1430</fpage><lpage>1439</lpage><year>2008</year></citation></ref>
<ref id="b29-ijmm-30-05-1021"><label>29.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tergaonkar</surname><given-names>V</given-names></name></person-group><article-title>NFkappaB pathway: a good signaling paradigm and therapeutic target</article-title><source>Int J Biochem Cell Biol</source><volume>38</volume><fpage>1647</fpage><lpage>1653</lpage><year>2006</year></citation></ref>
<ref id="b30-ijmm-30-05-1021"><label>30.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Luqman</surname><given-names>S</given-names></name><name><surname>Pezzuto</surname><given-names>JM</given-names></name></person-group><article-title>NFkappaB: a promising target for natural products in cancer chemoprevention</article-title><source>Phytother Res</source><volume>24</volume><fpage>949</fpage><lpage>963</lpage><year>2010</year></citation></ref>
<ref id="b31-ijmm-30-05-1021"><label>31.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhong</surname><given-names>Y</given-names></name><name><surname>Liu</surname><given-names>T</given-names></name><name><surname>Guo</surname><given-names>Z</given-names></name></person-group><article-title>Curcumin inhibits ox-LDL-induced MCP-1 expression by suppressing the p38MAPK and NF-kappaB pathways in rat vascular smooth muscle cells</article-title><source>Inflamm Res</source><volume>61</volume><fpage>61</fpage><lpage>67</lpage><year>2012</year></citation></ref>
<ref id="b32-ijmm-30-05-1021"><label>32.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jobin</surname><given-names>C</given-names></name><name><surname>Bradham</surname><given-names>CA</given-names></name><name><surname>Russo</surname><given-names>MP</given-names></name><etal/></person-group><article-title>Curcumin blocks cytokine-mediated NF-kappa B activation and proinflammatory gene expression by inhibiting inhibitory factor I-kappa B kinase activity</article-title><source>J Immunol</source><volume>163</volume><fpage>3474</fpage><lpage>3483</lpage><year>1999</year></citation></ref>
<ref id="b33-ijmm-30-05-1021"><label>33.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bharti</surname><given-names>AC</given-names></name><name><surname>Donato</surname><given-names>N</given-names></name><name><surname>Singh</surname><given-names>S</given-names></name><name><surname>Aggarwal</surname><given-names>BB</given-names></name></person-group><article-title>Curcumin (diferuloylmethane) down-regulates the constitutive activation of nuclear factor-kappa B and IkappaBalpha kinase in human multiple myeloma cells, leading to suppression of proliferation and induction of apoptosis</article-title><source>Blood</source><volume>101</volume><fpage>1053</fpage><lpage>1062</lpage><year>2003</year></citation></ref>
<ref id="b34-ijmm-30-05-1021"><label>34.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Johnson</surname><given-names>GL</given-names></name><name><surname>Lapadat</surname><given-names>R</given-names></name></person-group><article-title>Mitogen-activated protein kinase pathways mediated by ERK, JNK, and p38 protein kinases</article-title><source>Science</source><volume>298</volume><fpage>1911</fpage><lpage>1912</lpage><year>2002</year></citation></ref>
<ref id="b35-ijmm-30-05-1021"><label>35.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>A</given-names></name><name><surname>Zheng</surname><given-names>S</given-names></name></person-group><article-title>Curcumin inhibits connective tissue growth factor gene expression in activated hepatic stellate cells in vitro by blocking NF-kappaB and ERK signalling</article-title><source>Br J Pharmacol</source><volume>153</volume><fpage>557</fpage><lpage>567</lpage><year>2008</year></citation></ref>
<ref id="b36-ijmm-30-05-1021"><label>36.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lim</surname><given-names>JH</given-names></name><name><surname>Kwon</surname><given-names>TK</given-names></name></person-group><article-title>Curcumin inhibits phorbol myristate acetate (PMA)-induced MCP-1 expression by inhibiting ERK and NF-kappaB transcriptional activity</article-title><source>Food Chem Toxicol</source><volume>48</volume><fpage>47</fpage><lpage>52</lpage><year>2010</year></citation></ref>
<ref id="b37-ijmm-30-05-1021"><label>37.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Shehzad</surname><given-names>A</given-names></name><name><surname>Wahid</surname><given-names>F</given-names></name><name><surname>Lee</surname><given-names>YS</given-names></name></person-group><article-title>Curcumin in cancer chemo-prevention: molecular targets, pharmacokinetics, bioavailability, and clinical trials</article-title><source>Arch Pharm</source><volume>343</volume><fpage>489</fpage><lpage>499</lpage><year>2010</year></citation></ref>
<ref id="b38-ijmm-30-05-1021"><label>38.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Soares</surname><given-names>MP</given-names></name><name><surname>Bach</surname><given-names>FH</given-names></name></person-group><article-title>Heme oxygenase-1: from biology to therapeutic potential</article-title><source>Trends Mol Med</source><volume>15</volume><fpage>50</fpage><lpage>58</lpage><year>2009</year></citation></ref>
<ref id="b39-ijmm-30-05-1021"><label>39.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhu</surname><given-names>Z</given-names></name><name><surname>Wilson</surname><given-names>AT</given-names></name><name><surname>Luxon</surname><given-names>BA</given-names></name><etal/></person-group><article-title>Biliverdin inhibits hepatitis C virus nonstructural 3/4A protease activity: mechanism for the antiviral effects of heme oxygenase?</article-title><source>Hepatology</source><volume>52</volume><fpage>1897</fpage><lpage>1905</lpage><year>2010</year></citation></ref>
<ref id="b40-ijmm-30-05-1021"><label>40.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fillebeen</surname><given-names>C</given-names></name><name><surname>Pantopoulos</surname><given-names>K</given-names></name></person-group><article-title>Iron inhibits replication of infectious hepatitis C virus in permissive Huh7.5.1 cells</article-title><source>J Hepatol</source><volume>53</volume><fpage>995</fpage><lpage>999</lpage><year>2010</year></citation></ref>
<ref id="b41-ijmm-30-05-1021"><label>41.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Choi</surname><given-names>J</given-names></name><name><surname>Lee</surname><given-names>KJ</given-names></name><name><surname>Zheng</surname><given-names>Y</given-names></name><name><surname>Yamaga</surname><given-names>AK</given-names></name><name><surname>Lai</surname><given-names>MM</given-names></name><name><surname>Ou</surname><given-names>JH</given-names></name></person-group><article-title>Reactive oxygen species suppress hepatitis C virus RNA replication in human hepatoma cells</article-title><source>Hepatology</source><volume>39</volume><fpage>81</fpage><lpage>89</lpage><year>2004</year></citation></ref>
<ref id="b42-ijmm-30-05-1021"><label>42.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yano</surname><given-names>M</given-names></name><name><surname>Ikeda</surname><given-names>M</given-names></name><name><surname>Abe</surname><given-names>K</given-names></name><etal/></person-group><article-title>Oxidative stress induces anti-hepatitis C virus status via the activation of extracellular signal-regulated kinase</article-title><source>Hepatology</source><volume>50</volume><fpage>678</fpage><lpage>688</lpage><year>2009</year></citation></ref>
<ref id="b43-ijmm-30-05-1021"><label>43.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kuroki</surname><given-names>M</given-names></name><name><surname>Ariumi</surname><given-names>Y</given-names></name><name><surname>Ikeda</surname><given-names>M</given-names></name><name><surname>Dansako</surname><given-names>H</given-names></name><name><surname>Wakita</surname><given-names>T</given-names></name><name><surname>Kato</surname><given-names>N</given-names></name></person-group><article-title>Arsenic trioxide inhibits hepatitis C virus RNA replication through modulation of the glutathione redox system and oxidative stress</article-title><source>J Virol</source><volume>83</volume><fpage>2338</fpage><lpage>2348</lpage><year>2009</year></citation></ref>
<ref id="b44-ijmm-30-05-1021"><label>44.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brazil</surname><given-names>DP</given-names></name><name><surname>Yang</surname><given-names>ZZ</given-names></name><name><surname>Hemmings</surname><given-names>BA</given-names></name></person-group><article-title>Advances in protein kinase B signalling: AKTion on multiple fronts</article-title><source>Trends Biochem Sci</source><volume>29</volume><fpage>233</fpage><lpage>242</lpage><year>2004</year></citation></ref>
<ref id="b45-ijmm-30-05-1021"><label>45.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mannova</surname><given-names>P</given-names></name><name><surname>Beretta</surname><given-names>L</given-names></name></person-group><article-title>Activation of the N-Ras-PI3K-Akt-mTOR pathway by hepatitis C virus: control of cell survival and viral replication</article-title><source>J Virol</source><volume>79</volume><fpage>8742</fpage><lpage>8749</lpage><year>2005</year></citation></ref>
<ref id="b46-ijmm-30-05-1021"><label>46.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Street</surname><given-names>A</given-names></name><name><surname>Macdonald</surname><given-names>A</given-names></name><name><surname>Crowder</surname><given-names>K</given-names></name><name><surname>Harris</surname><given-names>M</given-names></name></person-group><article-title>The Hepatitis C virus NS5A protein activates a phosphoinositide 3-kinase-dependent survival signaling cascade</article-title><source>J Biol Chem</source><volume>279</volume><fpage>12232</fpage><lpage>12241</lpage><year>2004</year></citation></ref>
<ref id="b47-ijmm-30-05-1021"><label>47.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Porstmann</surname><given-names>T</given-names></name><name><surname>Griffiths</surname><given-names>B</given-names></name><name><surname>Chung</surname><given-names>YL</given-names></name><etal/></person-group><article-title>PKB/Akt induces transcription of enzymes involved in cholesterol and fatty acid biosynthesis via activation of SREBP</article-title><source>Oncogene</source><volume>24</volume><fpage>6465</fpage><lpage>6481</lpage><year>2005</year></citation></ref>
<ref id="b48-ijmm-30-05-1021"><label>48.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Park</surname><given-names>CY</given-names></name><name><surname>Jun</surname><given-names>HJ</given-names></name><name><surname>Wakita</surname><given-names>T</given-names></name><name><surname>Cheong</surname><given-names>JH</given-names></name><name><surname>Hwang</surname><given-names>SB</given-names></name></person-group><article-title>Hepatitis C virus nonstructural 4B protein modulates sterol regulatory element-binding protein signaling via the AKT pathway</article-title><source>J Biol Chem</source><volume>284</volume><fpage>9237</fpage><lpage>9246</lpage><year>2009</year></citation></ref>
<ref id="b49-ijmm-30-05-1021"><label>49.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yangxand Gabuzda</surname><given-names>D</given-names></name></person-group><article-title>Regulation of human immunodeficiency virus type 1 infectivity by the ERK mitogen-activated protein kinase signaling pathway</article-title><source>J Virol</source><volume>73</volume><fpage>3460</fpage><lpage>3466</lpage><year>1999</year></citation></ref>
<ref id="b50-ijmm-30-05-1021"><label>50.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Pleschka</surname><given-names>S</given-names></name><name><surname>Wolff</surname><given-names>T</given-names></name><name><surname>Ehrhardt</surname><given-names>C</given-names></name><etal/></person-group><article-title>Influenza virus propagation is impaired by inhibition of the Raf/MEK/ERK signalling cascade</article-title><source>Nat Cell Biol</source><volume>3</volume><fpage>301</fpage><lpage>305</lpage><year>2001</year></citation></ref>
<ref id="b51-ijmm-30-05-1021"><label>51.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cai</surname><given-names>Y</given-names></name><name><surname>Liu</surname><given-names>Y</given-names></name><name><surname>Zhang</surname><given-names>X</given-names></name></person-group><article-title>Suppression of coronavirus replication by inhibition of the MEK signaling pathway</article-title><source>J Virol</source><volume>81</volume><fpage>446</fpage><lpage>456</lpage><year>2007</year></citation></ref>
<ref id="b52-ijmm-30-05-1021"><label>52.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Smith</surname><given-names>KD</given-names></name><name><surname>Mezhir</surname><given-names>JJ</given-names></name><name><surname>Bickenbach</surname><given-names>K</given-names></name><etal/></person-group><article-title>Activated MEK suppresses activation of PKR and enables efficient replication and in vivo oncolysis by Deltagamma(1)34.5 mutants of herpes simplex virus 1</article-title><source>J Virol</source><volume>80</volume><fpage>1110</fpage><lpage>1120</lpage><year>2006</year></citation></ref>
<ref id="b53-ijmm-30-05-1021"><label>53.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zheng</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>J</given-names></name><name><surname>Johnson</surname><given-names>DL</given-names></name><name><surname>Ou</surname><given-names>JH</given-names></name></person-group><article-title>Regulation of hepatitis B virus replication by the ras-mitogen-activated protein kinase signaling pathway</article-title><source>J Virol</source><volume>77</volume><fpage>7707</fpage><lpage>7712</lpage><year>2003</year></citation></ref>
<ref id="b54-ijmm-30-05-1021"><label>54.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhu</surname><given-names>H</given-names></name><name><surname>Liu</surname><given-names>C</given-names></name></person-group><article-title>Interleukin-1 inhibits hepatitis C virus subgenomic RNA replication by activation of extracellular regulated kinase pathway</article-title><source>J Virol</source><volume>77</volume><fpage>5493</fpage><lpage>5498</lpage><year>2003</year></citation></ref>
<ref id="b55-ijmm-30-05-1021"><label>55.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Murata</surname><given-names>T</given-names></name><name><surname>Hijikata</surname><given-names>M</given-names></name><name><surname>Shimotohno</surname><given-names>K</given-names></name></person-group><article-title>Enhancement of internal ribosome entry site-mediated translation and replication of hepatitis C virus by PD98059</article-title><source>Virology</source><volume>340</volume><fpage>105</fpage><lpage>115</lpage><year>2005</year></citation></ref>
<ref id="b56-ijmm-30-05-1021"><label>56.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ndjomou</surname><given-names>J</given-names></name><name><surname>Park</surname><given-names>IW</given-names></name><name><surname>Liu</surname><given-names>Y</given-names></name><name><surname>Mayo</surname><given-names>LD</given-names></name><name><surname>He</surname><given-names>JJ</given-names></name></person-group><article-title>Up-regulation of hepatitis C virus replication and production by inhibition of MEK/ERK signaling</article-title><source>PLoS One</source><volume>4</volume><fpage>e7498</fpage><year>2009</year></citation></ref>
<ref id="b57-ijmm-30-05-1021"><label>57.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tai</surname><given-names>DI</given-names></name><name><surname>Tsai</surname><given-names>SL</given-names></name><name><surname>Chen</surname><given-names>YM</given-names></name><etal/></person-group><article-title>Activation of nuclear factor kappaB in hepatitis C virus infection: implications for pathogenesis and hepatocarcinogenesis</article-title><source>Hepatology</source><volume>31</volume><fpage>656</fpage><lpage>664</lpage><year>2000</year></citation></ref>
<ref id="b58-ijmm-30-05-1021"><label>58.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Oem</surname><given-names>JK</given-names></name><name><surname>Jackel-Cram</surname><given-names>C</given-names></name><name><surname>Li</surname><given-names>YP</given-names></name><etal/></person-group><article-title>Hepatitis C virus non-structural protein-2 activates CXCL-8 transcription through NF-kappaB</article-title><source>Arch Virol</source><volume>153</volume><fpage>293</fpage><lpage>301</lpage><year>2008</year></citation></ref>
<ref id="b59-ijmm-30-05-1021"><label>59.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lin</surname><given-names>W</given-names></name><name><surname>Tsai</surname><given-names>WL</given-names></name><name><surname>Shao</surname><given-names>RX</given-names></name><etal/></person-group><article-title>Hepatitis C virus regulates transforming growth factor beta1 production through the generation of reactive oxygen species in a nuclear factor kappaB-dependent manner</article-title><source>Gastroenterology</source><volume>138</volume><fpage>2509</fpage><lpage>2518</lpage><fpage>2518.e1</fpage><year>2010</year></citation></ref>
<ref id="b60-ijmm-30-05-1021"><label>60.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ray</surname><given-names>RB</given-names></name><name><surname>Steele</surname><given-names>R</given-names></name><name><surname>Basu</surname><given-names>A</given-names></name><etal/></person-group><article-title>Distinct functional role of hepatitis C virus core protein on NF-kappaB regulation is linked to genomic variation</article-title><source>Virus Res</source><volume>87</volume><fpage>21</fpage><lpage>29</lpage><year>2002</year></citation></ref>
<ref id="b61-ijmm-30-05-1021"><label>61.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>JC</given-names></name><name><surname>Chen</surname><given-names>WC</given-names></name><name><surname>Wu</surname><given-names>SF</given-names></name><etal/></person-group><article-title>Anti-hepatitis C virus activity of <italic>Acacia confusa</italic> extract via suppressing cyclooxygenase-2</article-title><source>Antiviral Res</source><volume>89</volume><fpage>35</fpage><lpage>42</lpage><year>2011</year></citation></ref>
<ref id="b62-ijmm-30-05-1021"><label>62.</label><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lee</surname><given-names>JC</given-names></name><name><surname>Tseng</surname><given-names>CK</given-names></name><name><surname>Wu</surname><given-names>SF</given-names></name><name><surname>Chang</surname><given-names>FR</given-names></name><name><surname>Chiu</surname><given-names>CC</given-names></name><name><surname>Wu</surname><given-names>YC</given-names></name></person-group><article-title>San-Huang-Xie-Xin-Tang extract suppresses hepatitis C virus replication and virus-induced cyclooxygenase-2 expression</article-title><source>J Viral Hepat</source><volume>18</volume><fpage>e315</fpage><lpage>e324</lpage><year>2011</year></citation></ref></ref-list>
<sec sec-type="display-objects">
<title>Figures</title>
<fig id="f1-ijmm-30-05-1021" position="float">
<label>Figure 1.</label>
<caption>
<p>Cytotoxicity of curcumin in Huh7.5-HCV cells is shown. Cells were initially seeded at 1&#x000D7;10<sup>5</sup> cells/well in 24-well plates, then treated with varying concentrations of curcumin or vehicle (0.1&#x00025; DMSO), for 24 h. Cell viability was measured by MTT assay. Measurement was obtained from three independent experiments. (<sup>&#x0002A;&#x0002A;&#x0002A;</sup>P&#x0003C;0.001 compared to vehicle).</p></caption>
<graphic xlink:href="IJMM-30-05-1021-g00.gif"/></fig>
<fig id="f2-ijmm-30-05-1021" position="float">
<label>Figure 2.</label>
<caption>
<p>Curcumin dose-dependently inhibits HCV replication. (A) Curcumin inhibits luciferase reporter gene activity in Huh7.5-HCV cells. Cells were subcultured at a density of 4&#x000D7;10<sup>5</sup> cells/well in 1 ml of culture medium in a 12-well plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. The cells were lysed and cell lysates were prepared for <italic>Renilla</italic> luciferase assay. (B) Curcumin inhibits HCV RNA expression in Huh7.5-HCV cells. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 6-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. Total RNA was isolated and analyzed by real-time RT-PCR. (C) Curcumin inhibits HCV protein expression in Huh7.5-HCV cells. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. Total protein was isolated and analyzed by western blot analysis. Measurement was performed in triplicate and was repeated three times.</p></caption>
<graphic xlink:href="IJMM-30-05-1021-g01.gif"/></fig>
<fig id="f3-ijmm-30-05-1021" position="float">
<label>Figure 3.</label>
<caption>
<p>Curcumin induces HO-1 protein expression in Huh7.5-HCV cells. (A) Time course of curcumin-induces HO-1 protein expression is shown. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 6&#x02013;48 h. Total protein was isolated and analyzed by western blot analysis. (B) Dose-dependent induction of HO-1 by curcumin is shown. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 4 ml of culture medium in a 10-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. Total protein was isolated and analyzed by western blot analysis. (C) Effect of curcumin on the expression of HO-1 and HCV proteins is shown. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. Total protein was isolated and analyzed by western blot analysis. The experiments were repeated three times.</p></caption>
<graphic xlink:href="IJMM-30-05-1021-g02.gif"/></fig>
<fig id="f4-ijmm-30-05-1021" position="float">
<label>Figure 4.</label>
<caption>
<p>Hemin dose-dependently inhibits HCV replication. (A) Hemin inhibits luciferase reporter gene activity in Huh7.5-HCV cells. Cells were subcultured at a density of 4&#x000D7;10<sup>5</sup> cells/well in 1 ml of culture medium in a 12-well plastic dish for 6 h. Hemin or DMSO was added to the medium for 24 h. The cells were lysed and cell lysates were prepared for the <italic>Renilla</italic> luciferase assay. (B) Effect of hemin on the expression of HO-1 and HCV proteins is shown. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Hemin or DMSO was added to the medium for 24 h. Total protein was isolated and analyzed by western blot analysis. The experiments were repeated three times.</p></caption>
<graphic xlink:href="IJMM-30-05-1021-g03.gif"/></fig>
<fig id="f5-ijmm-30-05-1021" position="float">
<label>Figure 5.</label>
<caption>
<p>The role of HO-1, AKT, ERK and NF-&#x003BA;B on curcumin-inhibited HCV protein expression is shown. (A) Knockdown of HO-1 partially reversed curcumin-inhibited HCV protein expression. Cells (3&#x000D7;10<sup>6</sup>) were seeded in a 10-cm dish for 6 h, and negative control small interfering (siRNA) (10 nM) or HO-1 siRNA (10 nM) was transfected into cells. Subsequent to a 6-h addition of siRNA, the medium was changed to fresh condition medium for 18 h, and the transfected cells were analyzed by western blotting (&#x0002A;P&#x0003C;0.05 and <sup>&#x0002A;&#x0002A;&#x0002A;</sup>P&#x0003C;0.001, in 2 groups, respectively). (B) Curcumin inhibited AKT, ERK and NF-&#x003BA;B. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Curcumin or DMSO was added to the medium for 24 h. Total cell lysates (up) or cytosol-nuclear fraction (down) were isolated by western blot analysis. Sp1 is a dominant nuclear protein and &#x003B1;-tubulin is a cytosolic protein. (C) Effect of AKT, ERK and NF-&#x003BA;B inhibitors on the HCV protein expression is shown. Cells were subcultured at a density of 1.5&#x000D7;10<sup>6</sup> cells in 8 ml of culture medium in a 10-cm plastic dish for 6 h. Chemical (LY, LY294002; U0, U0126; Ro, Ro1069920) or DMSO was added to the medium for 24 h. Total cell lysates were isolated for western blot analysis. (<sup>&#x0002A;&#x0002A;&#x0002A;</sup>P&#x0003C;0.001 compared to control). The experiments were repeated three times.</p></caption>
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