title: The pathophysiology of HCV induced B-cell clonal disorders.
abstract: Hepatitis C virus (HCV) has been shown in epidemiologic studies to be associated with immune system disorders. Primarily disorders that stem from B-cell regulatory control disturbance, such as mixed cryoglobulinemia (MC) and non-Hodgkin's lymphoma (NHL). The causative role of HCV in these disorders is supported by the response to anti-viral treatment. The understanding of the pathophysiological process leading from HCV infection to B-cell clonal expansion has improved significantly. Data supports an antigen-driven indirect stimulation of clonal expansion model, leading from oligoclonal to monoclonal expansion and in some instances to frank malignancy. HCV-E2 antigen has been suggested as a candidate antigen as well as NS3. Binding of the B-cell receptor by viral antigens coupled with direct binding of CD-81 by HCV-E2 has been shown to provide a strong proliferative signal. Additional regulatory elements are also affected in HCV-related B-cell clonal expansion, including the Fas and BLyS signaling mechanisms. Finally, genetic events such as bcl-2 rearrangement may also be involved in clonal expansion. In this review, evidence linking HCV with MC and NHL, as well as known events in the pathophysiological process are described.
authors.affiliation: Université Pierre et Marie Curie-Paris 6, CNRS, UMR 7087, Paris, F-75013 France.
authors.forename: Dan-Avi
authors.initials: DA
authors.lastname: Landau
authors.forename: David
authors.initials: D
authors.lastname: Saadoun
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Calabrese
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D001402:B-Lymphocytes / Q000276:immunology*; D003449:Cryoglobulinemia / Q000276:immunology* / Q000821:virology; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000276:immunology / Q000821:virology