The nuclear factor erythroid-derived 2, like 2 (Nrf2) transcription factor is a key regulator of the antioxidant defense system, and pharmacological activation of Nrf2 is a promising strategy for prevention of toxin-induced liver damage. However, the consequences of Nrf2 activation on liver regeneration (LR) have not been determined. To address this question, we generated mice expressing a constitutively active Nrf2 (caNrf2) mutant in hepatocytes. Expression of the transgene did not affect liver homeostasis. Surprisingly, however, there was no beneficial effect of Nrf2 activation on CCl 4 -induced liver injury and fibrosis. Most important, LR after partial hepatectomy was impaired in caNrf2-transgenic mice as a result of delayed hepatocyte proliferation and enhanced apoptosis of these cells after liver injury. Mechanistically, this involved up-regulation of the cyclin-dependent kinase inhibitor p15 and the proapoptotic protein Bcl2l11 (Bim). Using chromatin immunoprecipitation, we show that the p15 and Bcl2l11 genes are direct targets of Nrf2, which are activated under hyperproliferative conditions in the liver. Conclusion: Activated Nrf2 delays proliferation and induces apoptosis of hepatocytes in the regenerating liver. These negative effects of Nrf2 activation on LR should be considered when Nrf2-activating compounds are used for prevention of liver damage. (HEPATOLOGY 2014;60:670-678) See Editorial on Page 461 T he use of oxygen as an electron acceptor confronts aerobic organisms with the danger of reactive oxygen species (ROS) being formed as by-products of the respiratory chain. ROS formation can be further enhanced by nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, which are particularly abundant in inflammatory cells.1 Low levels of ROS are required for intracellular signaling, 2 but excessive levels damage all types of cellular macromolecules. To limit ROS-induced cell damage, aerobes developed strategies for efficient ROS detoxification. Of particular importance is the transcription factor nuclear factor erythroid-derived 2, like 2 (Nrf2), which controls expression of numerous genes encoding antioxidant proteins and ROS-detoxifying enzymes.
3Under homeostatic conditions, Nrf2 is retained in the cytoplasm by binding to Keap1, which also targets Nrf2 for proteasomal degradation. However, some Nrf2 molecules escape this inhibitory mechanism and translocate to the nucleus, where they bind to antioxidant response elements (AREs) in the promoter/ enhancer regions of their target genes. This leads to a basal expression of most Nrf2 target genes. In the