Abstract

Article1 June 2003free access HBXIP functions as a cofactor of survivin in apoptosis suppression Hiroyuki Marusawa Hiroyuki Marusawa The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Shu-ichi Matsuzawa Shu-ichi Matsuzawa The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Kate Welsh Kate Welsh The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Hua Zou Hua Zou IDUN Pharmaceuticals, San Diego, CA, 92121 USA Search for more papers by this author Robert Armstrong Robert Armstrong IDUN Pharmaceuticals, San Diego, CA, 92121 USA Search for more papers by this author Ingo Tamm Ingo Tamm The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author John C. Reed Corresponding Author John C. Reed The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Hiroyuki Marusawa Hiroyuki Marusawa The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Shu-ichi Matsuzawa Shu-ichi Matsuzawa The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Kate Welsh Kate Welsh The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Hua Zou Hua Zou IDUN Pharmaceuticals, San Diego, CA, 92121 USA Search for more papers by this author Robert Armstrong Robert Armstrong IDUN Pharmaceuticals, San Diego, CA, 92121 USA Search for more papers by this author Ingo Tamm Ingo Tamm The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author John C. Reed Corresponding Author John C. Reed The Burnham Institute, La Jolla, CA, 92037 USA Search for more papers by this author Author Information Hiroyuki Marusawa1, Shu-ichi Matsuzawa1, Kate Welsh1, Hua Zou2, Robert Armstrong2, Ingo Tamm1 and John C. Reed 1 1The Burnham Institute, La Jolla, CA, 92037 USA 2IDUN Pharmaceuticals, San Diego, CA, 92121 USA *Corresponding author. E-mail: [email protected] The EMBO Journal (2003)22:2729-2740https://doi.org/10.1093/emboj/cdg263 PDFDownload PDF of article text and main figures. ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinked InMendeleyWechatReddit Figures & Info Survivin is an anti-apoptotic protein that is overexpressed in most human cancers. We show that survivin forms complexes with a cellular protein, hepatitis B X-interacting protein (HBXIP), which was originally recognized for its association with the X protein of hepatitis B virus (HBX). Survivin–HBXIP complexes, but neither survivin nor HBXIP individually, bind pro-caspase-9, preventing its recruitment to Apaf1, and thereby selectively suppressing apoptosis initiated via the mitochondria/cytochrome c pathway. Viral HBX protein also interacts with the survivin–HBXIP complex and suppresses caspase activation in a survivin-dependent manner. Thus, HBXIP functions as a cofactor for survivin, and serves as a link between the cellular apoptosis machinery and a viral pathogen involved in hepatocellular carcinogenesis. Introduction SURVIVIN represents one of the most tumor-specific genes in the human genome (Velculescu et al., 1999). The 17 kDa survivin protein is scarcely expressed in normal adult tissues, but is found at high levels in most human cancers (Ambrosini et al., 1997). Normally, survivin is expressed only during late stages of the cell cycle (particularly mitosis and anaphase), where it associates with the mitotic spindle and related structures, performing functions important for chromosome segregation and cytokinesis (Li et al., 1998; Reed and Bischoff, 2000). However, many cancers contain constitutively high levels of cytosolic p17 survivin, and overexpression of this protein blocks apoptosis both in vitro in cultured cells and in vivo in transgenic mice through poorly defined mechanisms (Ambrosini et al., 1997; Grossman et al., 2001; Reed, 2001). Survivin contains a characteristic zinc-binding fold called the BIR domain. Many BIR-containing proteins suppress apoptosis when overexpressed, thus prompting the term inhibitor of apoptosis proteins (IAPs). The principal mechanism of apoptosis suppression by IAP family members, such as XIAP, has been defined. These proteins directly bind and suppress the activity of caspases (Deveraux and Reed, 1999), intracellular proteases responsible for apoptosis (reviewed in Cryns and Yuan, 1998). Although some studies have suggested that p17 survivin also binds and suppresses caspases, others have failed to demonstrate direct effects on these proteases (Banks et al., 2000; Verdecia et al., 2000; Shin et al., 2001). To provide an insight into the anti-apoptotic mechanism of survivin, we screened cDNA libraries for survivin-binding proteins, resulting in the discovery that hepatitis B X-interacting protein (HBXIP) associates with survivin. HBXIP was originally identified by its interaction with the HBX protein of hepatitis B virus (HBV) (Melegari et al., 1998), a putative oncogenic protein previously implicated in apoptosis regulation and other processes (reviewed in Murakami, 2001). We demonstrate here that HBXIP operates as a cofactor for survivin, allowing it to bind and suppress activation of pro-caspase-9, the apical protease in a mitochondrial pathway for cell death. The findings thus provide novel insights into the anti-apoptotic mechanism of survivin, and suggest a link between survivin and cancers associated with HBV infection. Results Survivin differs from XIAP in caspase inhibitory activity We compared the effects of purified recombinant survivin and XIAP on recombinant active caspase-3 in vitro. While XIAP potently suppressed caspase-3, survivin displayed no ability to suppress caspase-3 protease activity, as measured by the hydrolysis of the fluorigenic peptide substrate acetyl-Asp-Glu-Val-Asp-aminofluorocoumarin (Ac-DEVD-AFC) (Figure 1A). Even at a 1000-fold molar excess of survivin relative to active caspase-3, essentially no inhibition was observed. Similar results were obtained using caspase-7 and -9, with either wild-type survivin or a T34E survivin mutant designed to mimic the phosphorylated form of survivin (O'Connor et al., 2000). Again, XIAP inhibited, but survivin did not (data not shown). Figure 1.Differences in caspase suppression by survivin and XIAP. Comparisons were made of the effects of purified survivin (left panels) and XIAP (middle panels) on (A) recombinant active caspase-3 or (B and C) caspase-3-like protease activity induced in cell extracts by Cyt-c. Caspase activity was continuously measured, based on cleavage of Ac-DEVD-AFC fluorigenic substrate [relative fluorescence units (RFU)/min/μg]. In (A), 100 pM recombinant active caspase-3 was incubated with recombinant survivin (left panel) or XIAP (middle panel) or with control protein. In (B), purified survivin (left panel) or XIAP (middle panel), or control protein was added to 293 cell lysates concurrently with Cyt-c and dATP. In (C), survivin (left panel) or XIAP (middle panel) was added to cell extracts after Cyt-c and dATP. Data shown in the panels on the right are normalized relative to control protein (mean ± SD; n = 3). Download figure Download PowerPoint We then measured caspase activity in cell extracts, using exogenously supplied cytochrome c (Cyt-c) to trigger activation of caspases—a treatment known to cause Cyt-c-dependent oligomerization of the caspase activator Apaf1, which then binds and activates pro-caspase-9, followed by cleavage and activation of downstream protease caspase-3 (Zou et al., 1999). When purified recombinant survivin or XIAP was added to extracts prior to stimulation with Cyt-c, caspase activity in the cell lysates was suppressed in a concentration-dependent manner by both proteins (Figure 1B). However, if survivin or XIAP was added to extracts after stimulation with Cyt-c, then XIAP suppressed caspase activity, whereas survivin did not (Figure 1C). Although higher amounts of survivin protein were required for caspase suppression, compared with XIAP, we noted that survivin is rapidly degraded in cytosolic extracts (see Supplementary figure 1 available at The EMBO Journal Online), making quantitative comparisons difficult. Survivin binds HBXIP Since survivin inhibits caspase activation in cell extracts but not when purified, we reasoned that it might require a cofactor. To identify potential partners of survivin, we performed yeast two-hybrid cDNA library screens using survivin as a bait. From a pool of 64 candidate clones, 17 represented cDNAs encoding the HBXIP protein, with all clones encoding full-length protein (see Supplementary figure 2). HBXIP is a 91-amino-acid protein widely expressed in human tissues whose function is unknown (Melegari et al., 1998). We confirmed the direct association of survivin and HBXIP by protein-binding assays (Figure 2A) using purified recombinant His6-HBXIP and untagged survivin. Figure 2.HBXIP directly binds survivin. (A) In vitro binding experiments were performed using either purified recombinant survivin (untagged) or GST–XIAP incubated with His6-HBXIP, His6-TRAF3 or SMAC-His6 immobilized on nickel beads. Bound proteins were analyzed by immunoblotting using anti-survivin (upper panel) or anti-XIAP (middle panel) antisera. His6-tagged proteins were also analyzed by SDS–PAGE/immunoblotting using an anti-His6 antibody (lower panel). (B) Various fragments of survivin were produced by in vitro translation with [35S]L-methionine. Survivin fragments were then incubated with GST–CD40 control protein or GST–HBXIP immobilized on glutathione–Sepharose. Bound proteins were analyzed by autoradiography. The BIR domain is encompassed in residues 15–89. (C and D) 293T cells were transiently transfected with plasmids encoding myc-tagged survivin, mutant survivin lacking the BIR domain (del-SVV) or myc–XIAP, together with FLAG–HBXIP or FLAG–SIP (used as a negative control). Lysates were subjected to immunoprecipitation using anti-FLAG antibody (C and D, upper panel) or anti-myc antibody (D, middle panel). Immunoprecipitates were analyzed by immunoblotting using anti-myc antibody (C and D, upper panel) or anti-FLAG antibody (D, middle panel). Lysates were also blotted by anti-myc (C, middle panel, and D, lower panel) or anti-FLAG antibodies (C, lower panel). (E) Lysates from untransfected HepG2 cells used for immunoprecipitation with rabbit anti-survivin antisera, followed by blotting with chicken anti-HBXIP or rabbit anti-survivin antibodies. (F) Lysates from unfractionated 293 cells (T) and from subcellular fractions (M, membrane; C, cytoplasmic; N, nuclear), normalized for cell equivalents, were analyzed by immunoblotting using anti-HBXIP and anti-survivin. Blotting using anti-Hsp60, anti-caspase-3 and anti-PARP antibodies was also performed as markers for membrane (mitochondria), cytosolic and nuclear proteins, respectively. Download figure Download PowerPoint To map the region of survivin required for interaction with HBXIP, we prepared fragments of survivin by in vitro translation, and assayed their binding to purified GST–HBXIP. In this regard, survivin contains a single BIR (residues 15–88), followed by a dimerization domain (residues 89–126) and an α-helical region (residues 126–142) that mediates association with mitotic structures in dividing cells (Verdecia et al., 2000). Fragments of survivin retaining the BIR domain bound HBXIP in vitro, while fragments lacking it did not (Figure 2B). Thus, the BIR domain of survivin is necessary and sufficient for HBXIP binding in vitro. HBXIP binding to survivin in cells was confirmed by co-immunoprecipitation assays (Figure 2C and D). HBXIP bound to survivin but not to XIAP, BIR-deficient survivin or various irrelevant proteins such as SIP (Siah-interacting protein), confirming the specificity of the interaction of HBXIP with survivin. In contrast, Leu48, Leu55 and Ile62 mutants affecting the putative leucine zipper of HBXIP retained their ability to bind survivin, suggesting that this motif is not essential (data not shown). Binding of endogenous HBXIP to endogenous survivin was also detected by co-immunoprecipitation assays, using anti-survivin antibody to immunoprecipitate survivin, followed by immunoblot analysis of the resulting immune complexes using chicken anti-HBXIP antiserum (Figure 2E). Moreover, subcellular fractionation experiments confirmed that survivin and HBXIP reside in the same cellular compartment, with both proteins found predominantly in the cytosolic fraction of cells (Figure 2F). By immunostaining of tumor tissues, we also observed localization of both survivin and HBXIP predominantly in the cytosol of interphase cells (data not shown). HBXIP interaction with survivin is modulated by phosphorylation Phosphorylation of survivin at Thr34, probably by Cdc2, is required for its anti-apoptotic activity (O‘Connor et al., 2000). We therefore compared the ability of HBXIP to co-immunoprecipitate with wild-type (W) versus T34A mutant survivin (Figure 3A). Whereas HBXIP co-immunoprecipitated with survivin, it did not associate with survivin (T34A). To further explore the role of phosphorylation, we performed experiments where cells were transfected with dominant-negative Cdc2 (Figure 3B). Based on immunoblot analysis using a phospho-specific antibody that detects T34 phosphorylated survivin (O'Connor et al., 2000), expression of Cdc2 dominant-negative greatly reduced amounts of phosphorylated survivin in cells. In parallel, Cdc2 dominant-negative substantially reduced association of HBXIP with survivin, as demonstrated by co-immunoprecipitation assays. Moreover, a T34E phospho-mimic of survivin bound HBXIP with higher affinity compared with wild-type survivin in vitro (Figure 3C), confirming the importance of this residue in survivin for modulating interactions with HBXIP. We conclude, therefore, that phosphorylation of survivin is required for optimal association with HBXIP, presumably explaining the low proportion of total cellular HBXIP and survivin interacting in various binding assays (Figure 2A–E). Figure 3.Interaction of HBXIP and survivin is regulated by phosphorylation. (A) HEK293 cells co-transfected with plasmids encoding FLAG–HBXIP and either wild-type (W) myc–survivin or myc–survivin (T34A) were immunoprecipitated with anti-myc antibody, followed by immunoblotting using anti-FLAG antibody (upper panel). Lysates were also blotted by anti-myc antibody (lower panel). (B) Endogenous survivin was immunoprecipitated from HeLa cells that had been transfected with control or kinase-dead Cdc2 mutant (DN) together with FLAG–HBXIP. Immunoprecipitates were analyzed by immunoblotting using anti-FLAG antibody (upper panel) or an antibody specific for phophorylated Thr34 survivin [(p)-SVV] (middle panel). Lysates were also blotted by anti-survivin antibody (lower panel). (C) In vitro binding experiments were performed, incubating either 0.25 μg of His6-survivin (left panel) or His6-T34E-survivin (right panel) with 1 μg of GST–CD40 (CTR) or GST–HBXIP immobilized on glutathione–Sepharose in 0.5 ml of binding buffer. Bound proteins were analyzed by immunoblotting using anti-survivin (upper panel) antisera. ‘Input’ represents 25 ng of His6-survivin or His6-T34E- survivin. GST-tagged proteins were also analyzed by immunoblotting using anti-GST antibody (lower panel). Download figure Download PowerPoint HBXIP collaborates with survivin in suppressing caspase-9 activation To explore the functional significance of interaction of HBXIP with survivin, we evaluated the effects of recombinant HBXIP alone and in combination with survivin on activation of caspases in cell lysates stimulated with Cyt-c. At concentrations 80% reduction in the relative amount of large (∼35 kDa) subunit production when survivin and HBXIP were present (Figure 5C). Substituting various control proteins (e.g. GST, GST–CD40, His6-TRAF3) failed to inhibit Apaf1-induced activation of pro-caspase-9 (data not shown). Figure 5.Combination of HBXIP and survivin inhibits caspase-9 activation. Recombinant pro-caspase-9 was incubated with purified His6-Apaf1, Cyt-c and dATP, with or without recombinant HBXIP, survivin, or the combination of these proteins or various control (CTR) proteins. (A and B) Caspase-9 activity was measured by cleavage of fluorogenic substrate Ac-LEHD-AFC, or (C) proteolytic processing of ∼50 kDa pro-caspase-9 to large (∼35 kDa) and small (∼12 kDa) subunits was analyzed by immunoblotting analysis using anti-caspase-9 antibody. Data in (B) represent mean ± SD (n = 3), while data in (A) show representative enzyme progress curves. In (C), levels of recombinant proteins were also compared by immunoblotting using anti-HBXIP, anti-survivin and anti-His antibodies (lower three panels). Minus signs indicate addition of an equivalent amount of a control protein (GST–CD40 or His6-TRAF3) instead of survivin or HBXIP. Download figure Download PowerPoint Survivin–HBXIP blocks recruitment of pro-caspase-9 to Apaf1 To explore how survivin and HBXIP suppress pro-caspase-9 activation, we tested whether these proteins can bind pro-Capase-9 in vitro. GST–HBXIP was incubated with His6-pro-caspase-9 in the presence or absence of purified survivin. HBXIP-bound proteins were analyzed by immunoblotting. For comparison, experiments were also performed using purified active caspase-3 and -9 (Stennicke et al., 1999). Without survivin, GST–HBXIP failed to ‘pull down’ caspases (Figure 6A). However, when survivin was included, then pro-caspase-9 was pulled down with GST–HBXIP, but not with control GST–CD40 protein. GST–HBXIP also pulled down active caspase-9, in the presence survivin, but much less efficiently than pro-caspase-9. No association with caspase-3 was found. When survivin was used alone (as a GST fusion protein) for pull-down assays, no binding to caspases was detected. Thus, HBXIP–survivin complexes can bind pro-caspase-9. Figure 6.Combination of HBXIP and survivin inhibits recruitment of pro-caspase-9 to activated Apaf1. (A) GST–survivin, GST–CD40 or GST–HBXIP with or without purified survivin (untagged) was incubated with His6-pro-caspase-9, active His6-caspase-9 (lacking CARD domain) or His6-pro-caspase-3. GST fusion proteins were recovered using glutathione–Sepharose and bound proteins were detected by immunoblotting using anti-caspase-9 or anti-caspase-3 antisera. An equivalent amount of proteins was loaded directly onto gels as a control (‘input’). (B) [35S]pro-caspase-9 was incubated with His6-Apaf1, Cyt-c and dATP, with or without GST–HBXIP and survivin. His6-Apaf1 and associated proteins were recovered by adsorption to Ni-resin, and bound proteins were analyzed by autoradiography (for caspase-9) or immunoblotting using anti-Apaf1 or anti-Cyt-c antibodies. (C) Purified His6-Apaf1, His6-pro-caspase-9, Cyt-c and dATP were incubated without (left panel) or with (right panel) purified survivin and HBXIP. Proteins were analyzed by gel-sieve chromatography using immunoblotting to detect proteins in eluted fractions. (D) Caspase activity in column fractions was determined by monitoring cleavage of Ac-DEVD-AFC after addition of pro-caspase-3. Download figure Download PowerPoint Since HBXIP–survivin complexes bind pro-caspase-9, we tested whether these proteins interfere with binding of pro-caspase-9 to Apaf1. Accordingly, we incubated purified His6-Apaf1 with [35S]pro-caspase-9, Cyt-c and dATP, with or without survivin, HBXIP, or the combination of these proteins. Then, His6-Apaf1 was recovered on Ni-chelation resin, and associated proteins were analyzed by autoradiography (caspase-9) or by immunoblotting using anti-Cyt-c antibody. Without survivin and HBXIP, full-length ∼50 kDa pro-caspase-9 as well as the large (35–37 kDa) and small (∼12 kDa) subunits of processed caspase-9 were recovered with His6-Apaf1 on Ni-resin (Figure 6B). In contrast, when pro-caspase-9 was pre-incubated with HBXIP and survivin, the amount of pro-caspase and processed caspase-9 recovered with His6-Apaf1 on Ni-resin was significantly reduced, suggesting that HBXIP–survivin complexes prevented recruitment of pro-caspase-9 to activated Apaf1 (Figure 6B). When various control proteins were substituted for either survivin or HBXIP, then pro-caspase-9 association with Apaf1 was not blocked (data not shown). The combination of survivin and HBXIP also slightly reduced binding of Cyt-c to Apaf1 (Figure 6B), suggesting that the stability of this interaction may be reduced when pro-caspase-9 binding is blocked. To further address the inhibitory mechanism of survivin–HBXIP, we analyzed apoptosome complexes by gel-filtration chromatography (Figure 6C). Without survivin and HBXIP, two peaks of Apaf1 were detected, and caspase-9 co-eluted with the larger of these complexes (Figure 6C, left panel), as expected (Zou et al., 1999). In contrast, when adding survivin and HBXIP, Apaf1 oligomerization occurred normally but very little caspase-9 co-eluted with oligomerized Apaf1. Also, more of the caspase-9 was present in the pro-enzyme form (∼50 kDa as opposed to ∼35 kDa). Moreover, column fractions in which the majority of the pro-caspase-9 eluted also contained survivin and HBXIP (Figure 6C, right panel). Monitoring fractions for caspase-9 activity revealed markedly reduced caspase-9 activity when survivin and HBXIP were included (Figure 6D). We conclude, therefore, that the combination of HBXIP and survivin interferes with apoptosome assembly, preventing recruitment of pro-caspase-9 to oligomerized Apaf1. Survivin and HBXIP collaborate in suppressing apoptosis We contrasted effects of transfecting plasmids encoding survivin, HBXIP or both of these proteins on apoptosis induced by staurosporine (STS) and anti-Fas antibody, stimuli that operate through caspase-9-dependent and -independent pathways, respectively (Salvesen, 2002). Also, wild-type HBXIP was compared with a mutant containing the first 61 amino acids of HBXIP protein, del-HBXIP(1–61), which we empirically determined to show reduced binding to survivin (Figure 7). At the plasmid concentrations used, either survivin or HBXIP only slightly suppressed apoptosis in transfected HT1080 cells (Figure 7, lower panel). In comparison, Bcl-XL [which inhibits Cyt-c release from mitochondria (Yang et al., 1997)] and CrmA [which inhibits caspase-8 (Zhou et al., 1997)] suppressed apoptosis induced by STS and anti-Fas antibody, respectively, serving as positive controls. When survivin and HBXIP were co-expressed in HT1080 cells, then apoptosis induced by STS (but not Fas) was suppressed (Figure 7). Immunoblot analysis of transfected cells confirmed production of all proteins and demonstrated comparable levels of HBXIP and del-HBXIP(1–61) (data not shown). Together, these data demonstrate collaboration of survivin and HBXIP in selectively suppressing the caspase-9-dependent pathway for apoptosis, consistent with our in vitro data that these proteins block pro-caspase-9 activation. Figure 7.HBXIP/survivin selectively suppresses caspase-9-dependent apoptosis. Upper panel: full-length HBXIP and HBXIP(1–61) proteins were produced as GST fusions, purified and then tested for binding to His6-survivin or control protein (His6-TRAF3). Bound proteins were analyzed by immunoblotting using anti-GST antisera (upper panel). An equivalent amount of GST fusion protein was loaded directly in gels as a control (‘input’). Lower panel: HT1080 cells were transiently transfected with expression plasmids encoding myc–survivin, FLAG–HBXIP, FLAG–HBXIP(1–61), Bcl-XL (for STS) or CrmA (for anti-Fas), alone or in various combinations, with pEGFP marker plasmid, using pcDNA3 to normalize total DNA content. Then cells were cultured with STS or anti-Fas antibody, and the percentage of apoptotic cells was determined by DAPI staining (mean ± SD; n = 3) a day later. Download figure Download PowerPoint Caspase regulation by endogenous HBXIP and survivin To explore the role of HBXIP in the pathogenesis of human liver disease associated with HBV infection, we first analyzed the expression of this protein by immunoblotting in primary hepatocellular carcinoma tissues, as well as non-cancerous regions of the same livers of patients with chronic HBV infection. As a control for non-HBV infection, we also examined normal liver tissue from patients with metastatic colon cancer. Levels of HBXIP protein were elevated 2- to 7-fold in both cancerous and non-cancerous liver tissue of patients with chronic HBV infection compared with hepatic tissue without HBV infection (Figure 8A), based on scanning densitometry analysis of immunoblots and normalization to α-tubulin. Probing the same blots with anti-survivin antibody revealed elevated survivin protein in tumor tissue compared with non-cancerous regions of the same livers (Figure 8A). Figure 8.Elevations of survivin and HBXIP associated with caspase suppression. (A) Protein samples from tumors (T) and non-malignant tissue (NT) of three patients with HBV-related hepatocellular carcinoma and two normal livers specimens (N1 and N2) were normalized for protein content, and analyzed by SDS–PAGE/immunoblotting using antisera specific for HBXIP, survivin or α-tubulin. (B) Caspase activity in the same tissue samples was measured using the fluorigenic substrate Ac-DEVD-AFC after addition of Cyt-c and dATP (left panel) or granzyme B (right panel). Results are expressed relative to caspase activity generated in the normal liver specimen, N1 (mean ± SD; n = 3). Download figure Download PowerPoint Since the combination of survivin and HBXIP interferes with Cyt-c-induced activation of pro-caspase-9, we tested whether a correlation exists between elevated expression of these proteins in HBV-associated hepatocellular carcinomas and resistance to Cyt-c-induced caspase activation. Accordingly, lysates from liver tissues were normalized for total protein content, then incubated with Cyt-c and dATP to induce Apaf1-mediated activation of caspases. Compared with non-infected liver tissue, Cyt-c-inducible caspase activity was significantly reduced in lysates of both cancerous (P < 0.01) and non-cancerous (P < 0.01) liver tissue from patients with chronic HBV infection (Figure 8B, left panel), with induction of DEVD-cleaving caspase activity more depressed in cancerous tissues than non-cancerous tissues from HBV-infected individuals (P < 0.01). In contrast, no significant difference was found in caspase activity induced by exogenously added granzyme B (Figure 8B, right panel). Thus, HBV-associated elevations in expression of HBXIP correlate with selective resistance to Cyt-c in extracts from patient tissues. To determine whether HBXIP is necessary for the inhibitory effect of survivin, we used small-interfering RNA (siRNA) to reduce expression of endogenous HBXIP in HeLa cells. Transfection of HBXIP-specific but not control double-strand synthetic