Individuals from Hawaii and Guam have the highest rates of liver cancer in the U.S. Our proposed research will investigate the contribution of Cyanobacteria, the toxins they generate, and established risk factors to chronic liver disease (CLD). CLD is a major risk factor for the development of liver cancer. Cyanobacteria are naturally occurring bacteria that can be found in food and water sources. Their distribution on Guam is not well characterized. Preliminary data show that cyanotoxins can interact with established risk factors to influence liver cancer development. Established risk factors include hepatitis B and C, excessive alcohol consumption, and, more recently, metabolic syndrome (MetS)— including obesity, hyperlipidemia, insulin resistance, and non-alcoholic fatty liver disease (NAFLD).

Our work may provide critical knowledge to understand the basis of liver cancer disparities in understudied Pacific Island populations. This knowledge may contribute to the development of risk reduction and screening modalities targeting high-risk communities.

Specific Aims:

• To evaluate the association of oral Cyanobacteria and periodontal pathogens with liver fibrosis and steatosis and the modifying effects of viral hepatitis, alcohol, and MetS.
• To evaluate the association of salivary and serum Cyanotoxins with liver fibrosis and steatosis and the modifying effects of viral hepatitis, alcohol, and MetS