Introduction

Sodium-taurocholate Co-transporting Polypeptide (NTCP) is a transmembrane protein found in hepatocytes, and its primary role is to facilitate the transport of bile salts into hepatocytes from the bloodstream. 90% of human bile salts are recycled daily, so the function of NTCP is critical in providing bile salts to solubilize fats for digestion. NTCP also serves as a receptor for Hepatitis B (HBV) and Hepatitis D (HDV) viruses.

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Structure

Structures were determined by cryogenic electron microscopy (Cryo-EM) of NTCP in complex with antibodies or nanobodies, revealing two key conformations in NTCP's transport mechanism. There are nine transmembrane alpha helices traversing the plasma membrane, with the N-terminus located on the extracellular side of the plasma membrane and the C-terminus located on the intracellular side. The panel domain is formed by transmembrane helices TM1, TM5, and TM6. The core domain is formed by the packing of a helix bundle consisting of TM2, TM3, and TM4 with another helix bundle consisting of TM7, TM8, and TM9. The two helix bundles are related by pseudo two-fold symmetry. Transmembrane helices are connected by short loops as well as extracellular and intracellular alpha helices that lie nearly parallel to the membrane.

Domains

NTCP contains two characteristic domains: the core and panel domains. Movement of these two domains allows recognition and transport of bile salts into hepatocytes.

• Panel Domain: 1-44, 155-208
• Core domain: 45-154, 209-309

Proline/Glycine Hinge

Glycine and proline residues in the connecting loops and extra- and intracellular helices act as hinges in the mechanism of bile salt uptake. The flexibility allows separation of the core and panel domains, creating a pore open to the extracellular space and exposing critical Na+ binding sites. Once substrate binds the open-pore state, this hinge allows transition to close this pore relative to the extracellular side and open to the cytoplasmic side, thus allowing release of substrate into the cell.

Sodium Binding Sites

Significant Residues

The vast majority of residues involved in bile salt uptake are also involved in HBV/HDV infection. of Human NTCP have been shown to be vital for preS1 domain recognition along with bile salt uptake. Residues 157-165 (INSERT GREEN LINK) have also been shown to be vital for preS1 recognition and bile salt uptake. Altering residues in either of these two sections hinders preS1 binding and therefore HBV/HDV infection. However, these mutations also prevent bile salt uptake.

Function

Mechanism of Bile Salt Uptake

Bile salts recognize and bind to the . After binding, bile salts pass through the amphipathic pore and NTCP transitions into the . In this conformation, the pore once open to the extracellular side is now closed and is now open to the cytoplasmic side. Transition to the inward facing state allows release of bile salts and sodium ions. It is not yet known how this transition exactly proceeds.

Mechanism of HBV/HDV Infection

The HBV/HDV capsid must be myristoylated (INSERT BLUE LINK) in order for proper recognition by NTCP. Residues 2-48 are the most significant residues of HBV/HDV that are highly conserved amongst these viruses that are vital for infection. Specifically, residues 8-17 on HBV/HDV have been identified as the most important. These residues are NPLGFFPDHQ. There are two proposed mechanisms as to how exactly HBV/HDV bind to NTCP and enter the cell. In both mechanisms, there is an initial translocation of the myristoylated preS1 HBV/HDV virus to interact with the host cell (hepatocyte). The first mechanism involves the myristoyl group of preS1 binding to the host cell membrane, not NTCP, and residues P8-H17 interacting with NTCP residues 157-165. The second mechanism involves the myristoyl group of preS1 binding directly into the open-pore of NTCP interacting with residues 157-165. In both proposed mechanisms, the interactions with the extracellular residues 84-87 of NTCP is unknown.

Medical Relevance