Role of geranylgeranylacetone as non-toxic HSP70 inducer in liver surgery: clinical application

Heat shock proteins (HSPs) are rapidly synthesized into cells in response to various types of physical or chemical insults and induce potent resistance to the stressors. A stress-inducible HSP70 is not expressed in normal conditions, but once HSP70 is excessively induced under various environmental stresses, HSP70-expressing cells can survive even under lethal conditions. In this review, we focused on the potential role of HSPs particularly HSP70 in liver surgery. A non-toxic HSP70 inducer, geranylgeranylacetone (GGA), has been introduced to exert a potent cytoprotective action against liver injury after ischemia/reperfusion, massive hepatectomy and liver transplantation in animal experiments. We have tried to explain possible therapeutic benefits of GGA in liver surgery. However, any dependable clinical application has not been done. One of the reasons is that any randomized clinical trial has not being carried out in clinical cases. Therefore, we have advocated the national scale randomized clinical trial for dependable clinical application of GGA.