Cholestasis in hepatitis E virus infection

Table 1 Possible mechanisms of cholestasis in patients with hepatitis E

Types/cause	Proteins involved	Ref.
Prehepatic-type/bilirubin overloads, hemolysis		[26,27]
Hepatic-type/impaired conjugation, impaired uptake (hepatitis or inherited genome mutations), impaired canalicular secretion (hepatitis, drugs, sex hormones or inherited genome mutations)	(Sinusoidal uptake of blood, etc.) SLCO1B1, SLCO1B3, SLC10A1, SLC22A1, MRP3, MRP4, OST-α/β, FXR, PXR (Transport of bile salt, etc.) BSEP, MRP2, FIC1, MDR3, ABC G5/G8, MDR1, FXR, PXR, CAR, PPARα	[6,28]
Posthepatic-type/ductular diseases (primary biliary cholangitis, primary sclerosing cholangitis or biliary duct obstruction by gallstones or malignancies)	(Secretion from hepatocytes to canaliculus) CFTR, ASBT, OST-α/β, MBO5B, FXR	[7-13,29]

SLCO1B1: Soluble carrier organic anion transporter family 1B1; SLCO1B3: Soluble carrier organic anion transporter family 1B3; NTCP: Na taurocholate cotransporter protein; OCT1: Organic cation transporter 1; MRP3: Multidrug resistance protein family 3; OST-α/β: Organic solute transporter-α/β; FXR: Farnesoid X receptor; PXR: Pregnane X receptor; BSEP: Bile salt export pumps; MRP2: Multidrug resistance protein 2; FIC1: Familial intrahepatic cholestasis 1; MDR3: Multiple drug resistance protein 3; MDR1: Multiple drug resistance protein 1; CAR: Constitutive androstane receptor; PPARα: Peroxisome proliferator-activated receptor alpha; CFTR: Cystic fibrosis transport regulator; ASBT: Apical sodium-dependent bile salt transporter; MBO5B: Myosin VB.