title: Enhanced monocyte Th1 cytokine production in HCV-infected cryoglobulinemic patients.
abstract: OBJECTIVE
  The etiologic link between chronic hepatitis C virus (HCV) infection and mixed cryoglobulinemia is well established, while its prognostic significance within the context of HCV-related hepatitis is not as clear. Patients with an HCV-related cryoglobulinemic syndrome oft have mild liver disease, an aspect that can be influenced by an individual's Th1/Th2 orientation. Our goal was to document stigmata of differentiate cytokine production in this subgroup of patients.
  
  
  METHODS
  Fifteen patients with chronic HCV-related liver disease (CLD) and a cryoglobulinemic syndrome (CRYO) were compared to age/sex matched CLD controls with negative cryocrit. Cultured monocytes were stimulated with either Staphylococcus aureus (SAC) or lipopolysaccharide (LPS).
  
  
  RESULTS
  The protein concentrations of TNF-alpha and of the Th1-type cytokines interleukin (IL)-12 and IL-18 were significantly greater in the CRYO group, while IL-10 (a Th2 cytokine) levels were greater in the control group.
  
  
  CONCLUSIONS
  The clinical distinctiveness of the two groups was reflected at the cytokine level. The cryoglobulinemic patients studied showed a greater Th1 polarization than their cryoglobulin-negative counterparts. This enhanced production of Th1-type cytokines is seemingly not able to rid the host of infection but may account for a milder course of liver disease.
authors.affiliation: Dipartimento di Medicina Interna, Cardioangiologia ed Epatologia, Università degli Studi di Bologna, Bologna, Italy. sloffred@yahoo.com
authors.forename: Stefano
authors.initials: S
authors.lastname: Loffreda
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
authors.forename: Loredana
authors.initials: L
authors.lastname: Mele
authors.forename: Francesco B
authors.initials: FB
authors.lastname: Bianchi
authors.forename: Marco
authors.initials: M
authors.lastname: Lenzi
mesh_terms: D000328:Adult; D000368:Aged; D002478:Cells, Cultured; D003449:Cryoglobulinemia / Q000209:etiology / Q000276:immunology*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000276:immunology*; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D018664:Interleukin-12 / Q000378:metabolism; D020382:Interleukin-18 / Q000378:metabolism; D008070:Lipopolysaccharides / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology / Q000378:metabolism* / Q000821:virology; D013211:Staphylococcus aureus; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D020382:Interleukin-18; D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D018664:Interleukin-12