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Journal of Clinical and
Translational Research Propranolol as a treatment for HCC

1. Introduction aspiration to contribute to the ongoing efforts of identifying
novel therapeutics for this aggressive kind of liver cancer.
1.1. General overview of hepatocellular carcinoma
(HCC) 2. Molecular mechanisms of HBV in the
Globally, HCC ranks fifth in the frequency of new development of HCC
occurrences, with 500,000 – 1,000,000 cases reported 2.1. HBV
yearly. Up to 80% of HCC cases are found in developing
nations, with sub-Saharan Africa and Southeast Asia HBV, a small pathogenic enveloped virus, belongs to
having the most significant incidence rates. HCC has the Hepadnaviridae family. Among DNA viruses, HBV
1,2
been the Taiwan region’s primary source of cancer-related is distinct since an RNA intermediate is utilized as an
9,10
fatalities since 1984. In the Taiwan region, 8,000 new intermediate in its DNA genome replication. The reverse
instances of HCC are discovered each year, and about transcriptase (the enzyme for DNA replication by reverse
7,000 HCC deaths occur annually. Around the world, transcription), three envelope glycoproteins, and the C
3
hepatitis B virus (HBV) infections account for over half of protein of the viral core (the chief component of the viral
all HCC cases, whereas hepatitis C virus (HCV) infections nucleocapsid) are all translated from the four open reading
account for roughly one-third. However, the proportion frames (ORFs) of the small, 3.2 kb HBV DNA genome.
of HCC caused by these viruses varies significantly by HBV is transmitted by contact with infected blood or
demographic, and there is evidence that the prevalence of body fluids in the same manner as HIV. In comparison
HCV globally is significantly underreported. Developed to HIV, HBV is 50 – 100 times more infectious. Malaise,
11
4
Western countries have a low prevalence of HCC, exhaustion, jaundice, and skin and sclera discoloration are
although there has been a rising trend over the past common symptoms of hepatitis, an inflammation of the
20 years. These two viruses account for over 80% of all liver which is brought on by liver malfunction and high
HCC cases worldwide, making them the two main risk blood bilirubin levels. It is estimated that 350 million
5
factors for developing HCC. Non-viral variables, such as people globally have chronic HBV. Up to 40% of these
alcohol use as well as aflatoxin B1, and other chronic liver people will experience problems from HCC and cirrhosis.
disorders, are less frequently associated with HCC risk. Chronic HBV carriers have an annual risk of <1%, but
2,5
Although several Asian and African nations are known individuals who also have cirrhosis have an annual risk of
to have a high incidence of HCC, there has been a more 2 – 3%. About 70 – 80% of HBV-related HCC develops in
recent rise in the condition in nations such as the United cirrhotic livers, whereas the remainder of HCC develops
States. Environmental pollutants, alcohol and drug abuse, in livers that do not have cirrhosis. The formation of HCC
autoimmune diseases, genetics, obesity, high hepatic iron in people with chronic hepatitis B is a multistage, complex
levels, and infections with hepatotropic viruses have all process that involves the interaction of the host and the
been associated with HCC development. Regardless of the environment. HBV is not immediately cytopathic. Gender,
5
condition’s cause, patients with chronic viral infections are age, cigarette smoking, alcohol use, chemical carcinogens,
likely to develop liver cirrhosis, a significant risk factor for hormones, and genetic vulnerability are among the chronic
carcinogenesis. 6 HBV-associated risk factors for HCC. 6
Finding effective HCC therapies is critical. Effective
medical interventions can vastly enhance patient outcomes, 2.2. Overview of HBV replication
increase survival rates, and improve the quality of life for The Hepadnaviridae family of viruses, of which HBV
patients suffering from this condition. Furthermore, is a part, can result in persistent liver infections. Each
7
improvements in HCC treatment will lessen the strain hepadnavirus appears to have a restricted host range
on health-care systems by eliminating the requirement dictated by intracellular signaling components and
for costly interventions such as palliative care or liver a cell-surface receptor. The hepadnavirus known as
5
transplantation. Finding successful HCC treatments will HBV reproduces by use of RNA. The 3.2 kb partially
also give patients and their families hope and provide them double-stranded relaxed circular DNA (rcDNA) of
with a chance to battle this terrible enemy. In addition, HBV is converted into covalently closed circular DNA
it would open the door for more investigation into the (cccDNA) after it enters hepatocytes. All viral mRNAs
biology of liver cancer, allowing researchers to identify new are transcriptionally transcribed from the cccDNA, which
therapeutic targets and create groundbreaking strategies to is organized as a minichromosome by both viral and
8
fight HCC. In this paper, we aim to examine propranolol’s cellular histone and non-histone proteins. Recurrence
potential as a treatment for HCC by thoroughly examining of the disease is possible even after successful treatment
the available literature and research findings as part of our and HBsAg removal since HBV replication would still

Volume 11 Issue 4 (2025) 19 doi: 10.36922/JCTR025080010