Ribavirin: Difference between revisions
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Immunomodulation by Ribavirin may be responsible for the drug’s antiviral properties. It has been suggested that the natural CD4+ helper T cell response may be altered in the presence of Ribavirin. It is thought that ribavirin may enhance the T helper 1 response, resulting in greater clearance of virus <ref>doi: 10.1111/j.1478-3231.2008.01896.x</ref>. However, there is conflicting evidence suggesting that the T helper 2 response may be implicated in this process instead <ref>doi: 10.1111/j.1440-1746.2008.05320.x</ref>. Another possible mechanism involves the enhancement of interferon-stimulated gene (ISG) expression by Ribavirin. When a cell becomes infected with a virus, it may release interferons. Interferons are signaling molecules that function in a paracrine fashion to induce an antiviral state in neighboring cells, protecting them from infection. Ribavirin is thought to enhance the interferon signaling pathway <ref>doi: 10.1002/hep.21853</ref>, resulting in a wider antiviral response. This theory has been supported in studies using cell culture models <ref>doi: 10.1002/hep.23985</ref>. It has also been suggested that the relationship between Ribavirin and inosine 5’-monophosphate dehydrogenase (IMPDH) may impact this process. IMPDH play a significant role in the guanine nucleotide synthesis pathway. It results in the conversion of inosine 5’-monophosphate to xanthine 5’-monophosphate, which is an intermediate for the nucleotide guanosine <ref>doi: 10.1002/chin.200823265</ref>. Therefore, modulation of IMPDH activity affects a cell’s reservoir of guanosine. Ribavirin has been shown to function as a competitive inhibitor for IMPDH <ref>PMID: 4197928</ref>. Because guanosine triphosphate (GTP) plays a critical role in the viral genome replication process, inhibition of IMPDH would result in the prevention of viral replication. | Immunomodulation by Ribavirin may be responsible for the drug’s antiviral properties. It has been suggested that the natural CD4+ helper T cell response may be altered in the presence of Ribavirin. It is thought that ribavirin may enhance the T helper 1 response, resulting in greater clearance of virus <ref>doi: 10.1111/j.1478-3231.2008.01896.x</ref>. However, there is conflicting evidence suggesting that the T helper 2 response may be implicated in this process instead <ref>doi: 10.1111/j.1440-1746.2008.05320.x</ref>. Another possible mechanism involves the enhancement of interferon-stimulated gene (ISG) expression by Ribavirin. When a cell becomes infected with a virus, it may release interferons. Interferons are signaling molecules that function in a paracrine fashion to induce an antiviral state in neighboring cells, protecting them from infection. Ribavirin is thought to enhance the interferon signaling pathway <ref>doi: 10.1002/hep.21853</ref>, resulting in a wider antiviral response. This theory has been supported in studies using cell culture models <ref>doi: 10.1002/hep.23985</ref>. It has also been suggested that the relationship between Ribavirin and inosine 5’-monophosphate dehydrogenase (IMPDH) may impact this process. IMPDH play a significant role in the guanine nucleotide synthesis pathway. It results in the conversion of inosine 5’-monophosphate to xanthine 5’-monophosphate, which is an intermediate for the nucleotide guanosine <ref>doi: 10.1002/chin.200823265</ref>. Therefore, modulation of IMPDH activity affects a cell’s reservoir of guanosine. Ribavirin has been shown to function as a competitive inhibitor for IMPDH <ref>PMID: 4197928</ref>. Because guanosine triphosphate (GTP) plays a critical role in the viral genome replication process, inhibition of IMPDH would result in the prevention of viral replication. | ||
Ribavirin has also been shown to act as an inhibitor for eIF4E, a protein of the translation initiation complex <ref>doi: 10.1073/pnas.0406927102</ref> | Ribavirin has also been shown to act as an inhibitor for eIF4E, a protein of the translation initiation complex <ref>doi: 10.1073/pnas.0406927102</ref>. Because of its structural similarity to guanosine, it mimics the 7-methyl guanosine mRNA cap, preventing translation. This would result in reduced capacity for viral replication within an infected cell. The Hepatitis C viral genome is replicated by RNA-dependent RNA polymerase (RdRp). A modified form of Ribavirin, Ribavirin 5’-triphosphate (RTP) is also believed to directly inhibit RdRp activity <ref>doi: 10.1002/rmv.483</ref>, resulting in lower rates of genome replication. If Ribavirin is converted to the monophosphate form, RMP, it is believed to be incorporated into the viral genome, functioning as a mutagen. | ||