9, 13 Peak hepatocyte proliferation in the KO was delayed by 24 hours and appears to have been compensated by alternate molecular mechanisms bypassing the requirement for β-catenin for proliferation. However, despite an increase in atypical ductular proliferation, the KO livers continue to show significantly greater intrahepatic

cholestasis and biliary dysfunction as evident by increased alkaline phosphatase and bilirubin. This appears to be due to an increase in hepatic fibrosis that is evident in KO livers at this stage. Indeed, it has been independently shown that the proliferating cholangiocytes and atypical ductules are a source of profibrotic cytokines including tumor necrosis factor alpha (TNFα), platelet-derived growth factor (PDGF), transforming growth factor beta (TGFβ), and osteopontin and cause activation of hepatic stellate cells and fibrosis.2 Another noteworthy observation in this study consisted of a spontaneous Pexidartinib repopulation of the KO liver with β-catenin-positive hepatocytes after chronic DDC injury. A careful tracking of the β-catenin-positive cells reveals the presence of check details occasional hepatocytes at baseline in a KO liver that escape albumin-cre-dependent β-catenin deletion, highlighting an imperfect recombination. Indeed, suboptimal albumin-cre-driven recombination has also been reported

recently for dicer-floxed and β-catenin-floxed mice.14, 15 At baseline, none of the β-catenin-positive cells were positive for any oval cell or biliary

markers such as A6, but were positive for hepatocyte-enriched transcription factor such as CEBPα and for epithelial markers such Vildagliptin as E-cadherin. In fact, all cholangiocytes, which are normally strongly positive for β-catenin, were negative for this marker at the outset in the KO.9 The significance of some hepatocytes escaping cre-deletion is unclear and appears to not contribute to hepatic functions at baseline because these livers continue to lack several β-catenin targets, as has been reported by multiple laboratories.9, 16-18 Similarly, these “escaped” hepatocytes do not undergo expansion during regeneration after partial hepatectomy.9, 13 Also, a counterintuitive increase in hepatic tumorigenesis observed in the KO livers in response to diethyl-nitrosamine (DEN) alone or DEN and phenobarbital was not due to expansion of β-catenin-positive hepatocytes, as predominant subset of tumors were negative for β-catenin and its targets such as GS.19, 20 Interestingly, a recent study reports a higher incidence of spontaneous hepatocellular carcinoma (HCC) in KO, and these tumors were composed of β-catenin-positive tumor cells.21 However, this has not been observed by two other independent studies.19, 20 β-Catenin-positive hepatocytes do became relevant during sustained hepatic injury such as continuous DDC diet administration over 150 days.