In this study, the authors demonstrate www.selleckchem.com/products/azd9291.html relatively high hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) seroconversion in HBeAg-positive CHB patients whose baseline ALT levels were 10-20 times the upper limit of normal (�� ULN) and who received LDT monotherapy immediately. Innovations and breakthroughs Recent reports have highlighted the importance of baseline characteristics, such as serum hepatitis B virus (HBV) DNA level, ALT level and histological grade and stage, in antiviral therapy. This is the first study to report the antiviral effect of LDT on HBeAg-positive patients whose baseline ALT level was 10-20 �� ULN, showing the HBeAg seroconversion rate was 37.5% at 52 wk. More encouragingly, our results also showed 7.5% (3/40) patients had HBsAg seroconversion at 52 wk after LDT treatment.

Applications By understanding that the antiviral results are related to the baseline ALT levels in addition to HBV DNA titer, this study may represent a future strategy for therapeutic intervention in CHB patients with high baseline ALT level. Terminology ALT is a common indicator of liver damage and is one of the key predictors of initiation of antiviral therapy. This study suggests that high baseline ALT level is a strong predictor for optimal results during LDT treatment. Peer review This study shows favorable results in patients with high baseline ALT values. The authors conclude that in patients with high baseline ALT levels antiviral treatment with LDT should be started immediately. Footnotes Supported by The China National S&T Major Project (to Yang YD), Grant No.

R20090018; and the Department of Science and Technology of Zhejiang Province, China (to Zheng L), Grant No. 2009C33009 Peer reviewers: Andrej Potthoff, MD, Department of Gastroenterology, Hepatology, Endocrinology, Hannover Medical School, Hannover, 30625, Germany S- Editor Wang YR L- Editor Logan Brefeldin_A S E- Editor Lin YP
NOD-like receptor (NLR)3 proteins form a family of intracellular pathogen-recognition receptors with more than 24 members in humans and over 200 members in lower metazoans (1,�C3). The NLR NOD2 is constitutively expressed in monocytes and intestinal Paneth cells (4, 5) and can be induced in various cell types including intestinal epithelial cells (6, 7). NOD2 serves as an intracellular pathogen sensor that requires muramyl dipeptide (MDP) as a minimal motif to trigger activation of the transcription factor NF-��B (4). Mutations in the gene encoding for NOD2 have been associated with a genetic predisposition to chronic inflammatory disorders (8,�C11) including Crohn disease, a human chronic inflammatory bowel disease.