Hepatitis C Virus Induces the Cannabinoid Receptor 1

Background

Activation of hepatic CB₁ receptors (CB₁) is associated with steatosis and fibrosis in experimental forms of liver disease. However, CB₁ expression has not been assessed in patients with chronic hepatitis C (CHC), a disease associated with insulin resistance, steatosis and metabolic disturbance. We aimed to determine the importance and explore the associations of CB₁ expression in CHC.

Methods

CB₁ receptor mRNA was measured by real time quantitative PCR on extracted liver tissue from 88 patients with CHC (genotypes 1 and 3), 12 controls and 10 patients with chronic hepatitis B (CHB). The Huh7/JFH1 Hepatitis C virus (HCV) cell culture model was used to validate results.

Principal Findings

CB₁ was expressed in all patients with CHC and levels were 6-fold higher than in controls (P<0.001). CB₁ expression increased with fibrosis stage, with cirrhotics having up to a 2 fold up-regulation compared to those with low fibrosis stage (p<0.05). Even in mild CHC with no steatosis (F0-1), CB₁ levels remained substantially greater than in controls (p<0.001) and in those with mild CHB (F0-1; p<0.001). Huh7 cells infected with JFH-1 HCV showed an 8-fold upregulation of CB₁, and CB₁ expression directly correlated with the percentage of cells infected over time, suggesting that CB₁ is an HCV inducible gene. While HCV structural proteins appear essential for CB₁ induction, there was no core genotype specific difference in CB₁ expression. CB₁ significantly increased with steatosis grade, primarily driven by patients with genotype 3 CHC. In genotype 3 patients, CB₁ correlated with SREBP-1c and its downstream target FASN (SREBP-1c; R = 0.37, FASN; R = 0.39, p<0.05 for both).

Conclusions/Significance

CB₁ is up-regulated in CHC and is associated with increased steatosis in genotype 3. It is induced by the hepatitis C virus.