Page 24 - JCTR-11-4

Journal of Clinical and

Translational Research

REVIEW ARTICLE
Propranolol: Repurposing an old drug to

modulate tumor growth, angiogenesis, and
immunity in hepatocellular carcinoma

Iman Owliaee 1 , Mehran Khaledian 2 , Faezeh Ramezani 3 , and
4
Ali Shojaeian *
1 Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences,
Hamadan, Iran
2 Department of Medical Entomology, Faculty of Medicine, Hamadan University of Medical Sciences,
Hamadan, Iran
3 Division of Medical Biotechnology, Department of Medical Laboratory Sciences, School of
Paramedical Sciences, Shiraz, Iran
4 Research Center for Molecular Medicine, Institute of Cancer, Avicenna Health Research Institute,
Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the key
*Corresponding author: risk determinants for hepatocellular carcinoma (HCC), which is a significant
Ali Shojaeian public health issue worldwide. Molecular mechanisms of HBV- and HCV-
(ali.shojaeian65@gmail.com;
a.shojaeian@umsha.ac.ir) related hepatocarcinogenesis are reviewed here, together with the therapeutic
potential of propranolol against HCC. HBV and HCV promote HCC development
Citation: Owliaee I, Khaledian M,
Ramezani F, Shojaeian A. through chronic inflammation, oxidative stress, and dysregulation of signaling
Propranolol: Repurposing an old pathways involved in proliferation, apoptosis, and immunity. Propranolol
drug to modulate tumor growth, demonstrates promise in inhibiting tumor growth, angiogenesis, and metastasis
angiogenesis, and immunity in
hepatocellular carcinoma. J Clin in HCC by modulating adrenergic receptors and the immune response. Evidence
Transl Res. 2025;11(4):18-29. suggests propranolol reduces inflammatory cytokines, enhances natural killer
doi: 10.36922/JCTR025080010 cell activity, and decreases the expression of immune checkpoint proteins
Received: February 18, 2025 such as programmed cell death protein 1 and T cell immunoglobulin and
mucin domain-containing protein-3 in HCC cells. Clinical studies indicate that
Revised: April 29, 2025
propranolol may lower HCC incidence and improve survival in cirrhotic patients.
Accepted: May 28, 2025 However, optimal dosing, long-term safety, and efficacy require further research
Published online: June 19, 2025 through large randomized controlled trials. Aim: This paper aims to review the
potential of propranolol as an adjuvant therapy for HBV/HCV-induced HCC by
Copyright: © 2025 Author(s).
This is an Open-Access article examining its antitumor, anti-angiogenic, and immunomodulatory effects.
distributed under the terms of the Conclusion: Propranolol represents a prospective adjuvant therapy for HBV/
Creative Commons AttributionNon- HCV-induced HCC that warrants continued investigation to fully elucidate its
Commercial 4.0 International (CC
BY-NC 4.0), which permits all therapeutic potential against this disease. Relevance for patients: Propranolol
non-commercial use, distribution, may improve outcomes in HBV/HCV-related HCC by reducing tumor growth,
and reproduction in any medium, angiogenesis, and immune evasion, offering a potential adjunct therapy to
provided the original work is
properly cited. enhance patient survival and prognosis.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Hepatocellular carcinoma; Hepatitis B virus; Hepatitis C virus; Propranolol;
regard to jurisdictional claims in
published maps and institutional Cirrhosis
affiliations.

Volume 11 Issue 4 (2025) 18 doi: 10.36922/JCTR025080010