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Review
. 2003 Jan-Feb;5(1):3-8.
doi: 10.1016/s1476-5586(03)80011-8.

Ribavirin in cancer immunotherapies: controlling nitric oxide augments cytotoxic lymphocyte function

Richard E Kast  1
Affiliations
Review

Ribavirin in cancer immunotherapies: controlling nitric oxide augments cytotoxic lymphocyte function

Richard E Kast. Neoplasia. 2003 Jan-Feb.

Abstract

Either ribavirin (RBV) or cyclophosphamide (CY) can shift an immune response from Th2 toward a Th1 cytokine profile. CY is used in this role in various current cancer immunotherapy attempts but with mixed success. More potent and reliable immunoadjuvants and Th1 response biasing methods are needed. RBV is used today mainly to augment interferon-alpha treatment of hepatitis C. RBV shifts an immune response from Th2 toward Th1 more effectively than CY and may be a safe and useful adjuvant for current cancer immunotherapeutic efforts. RBV is thought to act by inhibition of tetrahydrobiopterin synthesis. Tetrahydrobiopterin is an essential cofactor for all known isoforms of nitric oxide synthase. Lowered nitric oxide favors Th1 development as high levels favor Th2 weighting.

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Figures

Figure 1
Figure 1
Chemical structure of ribavirin: 244 Da, terminal half-life in humans, 298 hours.
Figure 2
Figure 2
Chemical structure of cyclophosphamide, 279 Da.
Figure 3
Figure 3
5,6,7,8-Tetrahydrobiopterin, BH4. The pteridine nucleus is numbered in standard fashion.
See this image and copyright information in PMC

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