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Hepatitis C Virus May Need Enzyme's Help To Cause Liver Disease PDF Print E-mail
Thursday, 10 July 2008 19:45

ScienceDaily (July 9, 2008) — A key enzyme may explain how hepatitis C infection causes fatty liver -- a buildup of excess fat in the liver, which can lead to life-threatening diseases such as cirrhosis and liver cancer, report University of Pittsburgh Graduate School of Public Health and School of Medicine researchers.

The study shows that an enzyme known to play a major role in lipid production, fatty acid synthase (FAS), was highly elevated in human liver cells exposed to the hepatitis C virus. While preliminary, the research suggests that testing for elevated levels of FAS could help determine which patients with hepatitis C virus may go on to develop more serious, long-lasting health consequences brought on by fatty liver.

Nearly 200 million people worldwide are infected by hepatitis C, including 4 million Americans. Seventy percent of people with hepatitis C develop chronic liver disease, and the infection is the leading reason for liver transplantation in the United States.

Unlike hepatitis A and B, there is no vaccine to prevent hepatitis C infection. Since hepatitis C typically has no symptoms, many people do not know they have the infection until they develop signs of liver failure or fatty liver, sometimes decades after infection. The virus replicates and mutates quickly, helping it to evade discovery and attack by the immune system and allowing it to slowly wreak damage on the liver.



"Our study has provided new insight into how hepatitis C causes fatty liver. This has important implications for future studies and efforts to understand how the virus causes an increase in fatty acid levels that can lead to serious liver conditions," said Tianyi Wang, Ph.D., assistant professor, Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, and the study's lead author.

To identify possible proteins in the hepatitis C virus linked to an increase in fatty acids, Dr. Wang worked with Thomas Conrads, Ph.D., co-director of clinical proteomics at the University of Pittsburgh Cancer Institute, and colleagues on a mass spectrometry-based proteomics approach in which they measured protein expression from liver cell cultures exposed to the hepatitis C virus. The approach sorted proteins based on their weight and electrical charge, looking for divergent patterns linked to the virus. Of the 175 proteins they identified, only FAS was highly elevated in cell cultures. Furthermore, when they blocked the expression of FAS, they noted a three to four times decrease in the level of the virus, indicating that FAS is directly linked to the virus's expression.

"Viruses are very complex, so it is challenging to determine what proteins may be at play in their survival and growth," said Dr. Wang. "The proteomic approach we used revealed many proteins linked to hepatitis C that may be worthy of further study, but FAS appears to be the protein most strongly associated with the production of fatty acids that can cause liver disease."

"Our next step in this research is to see how high the level of FAS is in tissue samples from hepatitis C patients and determine whether elevated FAS levels directly result in overproduction of fat in livers. If we learn that FAS is highly present in tissue, testing for it may be a way to predict those at risk for liver disease."

The study was published in the July 9 online issue of Hepatology. In addition to Drs. Wang and Conrads, other authors include Wei Yang, Ph.D., Sara Chadwick, B.S., and Shufeng Liu, Ph.D., University of Pittsburgh Graduate School of Public Health; Brian Hood, Ph.D., University of Pittsburgh Cancer Institute; Simon Watkins, Ph.D., University of Pittsburgh School of Medicine; and Guangxiang Luo, Ph.D., University of Kentucky College of Medicine.

The research was supported by a grant from the National Institutes of Health and University of Pittsburgh Central Research Development Funds.

http://www.sciencedaily.com/releases/2008/07/080709091717.htm

Comments (1)add comment
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written by George H. , July 30, 2008

Why some livers with HCV get fatty:
- HCV encodes for selenium, depleting glutathione peroxidase and thioredoxin reductase, two enzymes that maintain antioxidant levels in healthy cells. All antioxidants, plus selenium and zinc, are found to be depleted in populations with viral hepatitis.
- Resulting oxidative stress impairs the function of methionine synthase. This enzyme is required to recycle methionine for SAMe, which is needed to synthesise (phosphatidyl-)choline and l-carnitine.
- Experimental animals deprived of choline and methionine develop fatty livers. (Phosphatidyl)-choline is essential for liver cells to secrete fats in lipoprotiens, and l-carnitine is essential for the transfer of fatty acids to the mitochondria, where they are oxidised for energy. Without l-carnitine, unmetabolised fatty acyl co-A accumulates in liver cells. When methionine synthase is impaired by oxidative stress, fats accumulate in liver cells, at the same time as antioxidants dependent on methionine synthase also (co-enzyme Q10, glutathione) also decline. This sees the accumulated fats become oxidised: oxidised fats are repaired by glutathione peroxidase in a healthy cell.
- the answer? Early in Hep C, supplementing selenium, NAC, milk thistle and vitamin E and C and eating a healthy diet high in antioxidants, omega 3EFAs, and vegetables and whole nuts and seeds, etc and low in sugar, saturated fats, iron, and processed food will prevent the syndrome from progressing to liver damage.
- If beginning later, when symptoms are marked, it may be necessary to also supplement alpha-lipoic acid, plus taurine, glutamine, l-carnitine, choline, inositol, co-enzyme Q10, and B-complex vitamins.
- if cirrhosis has developed, it is necessary to supplement SAMe, which cannot be synthesised from l-methionine by a cirrhotic liver.

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