Towards predicting the therapeutic response in patients with hepatitis C.

摘要

The study by Angelico et al, recently published in Alimentary Pharmacology ft Therapeutics1 confirms the strong positive correlation between the level of HDL cholesterol at baseline and the virological response to the combined therapy using interferon-alfa and ribavirin. The direct relationship between HCV entiy into cells is a multi-step and slow process. It is believed that the initial capture of HCV particles by glycosaminoglycans and/or lipoprotein receptors is followed by coordinated interactions with the scavenger receptor class B type I (SR-BI), a major receptor of high-density lipoprotein (HDL), the CD81 tetraspanin, and the tight junction protein Claudin-1, ultimately leading to uptake and cellular penetration of HCV via low-pH endosomes. Competitive inhibition of HCV binding to SR-BI by HDL has been shown in vitro and is a better candidate than LDL receptor. If similar inhibition occurs in vivo, an elevated concentration of HDL may reduce the efficiency of infecting hepatocytes with HCV by competitively inhibiting HCV viral SR-BI receptor binding. This effect could be important during the initiation of therapy.