Metformin suppresses interleukin-22 induced hepatocellular carcinoma by upregulating Hippo signaling pathway

Background and Aims Epidemiological studies have shown direct associations between type 2 diabetes and the risk of cancers. Accumulating evidence indicates that metformin is profoundly implicated in preventing tumor development. However, the exact mechanism underlying the antitumor effects of metformin in hepatocellular carcinoma (HCC) is still not clear. Methods In this study, we investigated the effects of metformin on a mouse HCC model and interleukin-22 (IL-22)-associated carcinogenesis in vitro. Results We found that metformin significantly suppressed the incidence and tumor burden of HCC in the diethyl-nitrosamine-induced HCC mouse model. As expected, the expression of IL-22, an important factor involved in HCC progression, was markedly reduced by metformin. Treatment of HCC cells with metformin inhibited IL-22 induced cell proliferation, migration, and invasion, and promoted cell apoptosis. Furthermore, ectopic expression of IL-22 makes HCC more aggressive, whereas metformin largely compromised it in vitro and in vivo. Mechanistically, the whole transcriptome analysis and functional analysis revealed that Hippo signaling pathway was involved in the antitumor ability of metformin. Consistent with this, metformin directly inhibited LATS1/2 and activated Mst1/2, phosphorylated YAP1 in vitro. After blocking the Hippo pathway by XMU-MP-1, the inhibitor of MST1/2, the inhibitory effects by metformin were dramatically attenuated as shown by in vitro study. Conclusions Collectively, our findings illuminate a new regulatory mechanism, metformin activates Hippo signaling pathway to regulate IL-22 mediated HCC progression and provide new insights into its tumor-suppressive roles.