title: High values of CXCL10 serum levels in mixed cryoglobulinemia associated with hepatitis C infection.
abstract: OBJECTIVE
  No study has evaluated circulating CXCL10 in patients with mixed cryoglobulinemia (MC) and hepatitis C virus (HCV) chronic infection. The aim of this study is to measure inteferon-inducible protein 10 (CXCL10/IP-10), interferon-gamma (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) (Th1 cytokines) in a series of cryoglobulinemic patients and to correlate this parameter to the clinical phenotype.
  
  
  METHODS
  Serum CXCL10, IFN-gamma, and TNF-alpha were assayed in 102 patients with hepatitis C-associated cryoglobulinemia (MC + HCV), in 102 sex- and age-matched patients with type C chronic hepatitis without cryoglobulinemia (HCV+), and in 102 sex- and age-matched controls.
  
  
  RESULTS
  Cryoglobulinemic patients showed significantly higher mean CXCL10 serum levels than controls (P < 0.0001) or HCV+ patients (P < 0.0001) (397 +/- 132 pg/mL, 92 +/- 53 pg/mL, 280 +/- 149 pg/mL, respectively). Moreover, CXCL10 was significantly increased in 30 cryoglobulinemic patients with active vasculitis compared to those without it (460 +/- 104 pg/mL vs 369 +/- 139 pg/mL, respectively; P < 0.001). Both groups of MC + HCV patients with or without active vasculitis had serum CXCL10 significantly higher than HCV+ patients (P < 0.001, P= 0.02, respectively). IFN-gamma levels were not significantly different in MC + HCV than in HCV+ patients or controls. Serum TNF-alpha levels were significantly higher in MC + HCV than in HCV+ patients or controls (median [interquartile range]: 12.0 [9.8], 5.7 [5.4], 1.3 [2.1] pg/mL, respectively; P < 0.0001).
  
  
  CONCLUSIONS
  The study demonstrates high CXCL10 and TNF-alpha serum levels in patients with hepatitis C-associated cryoglobulinemia. Moreover, in MC + HCV patients, increased CXCL10 levels were significantly associated with the presence of active vasculitis.
authors.affiliation: Department of Internal Medicine, University of Pisa School of Medicine, Pisa, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Antonelli
authors.forename: Clodoveo
authors.initials: C
authors.lastname: Ferri
authors.forename: Poupak
authors.initials: P
authors.lastname: Fallahi
authors.forename: Silvia Martina
authors.initials: SM
authors.lastname: Ferrari
authors.forename: Marco
authors.initials: M
authors.lastname: Sebastiani
authors.forename: Daniela
authors.initials: D
authors.lastname: Ferrari
authors.forename: Marco
authors.initials: M
authors.lastname: Giunti
authors.forename: Silvia
authors.initials: S
authors.lastname: Frascerra
authors.forename: Simone
authors.initials: S
authors.lastname: Tolari
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Franzoni
authors.forename: Fabio
authors.initials: F
authors.lastname: Galetta
authors.forename: Santino
authors.initials: S
authors.lastname: Marchi
authors.forename: Ele
authors.initials: E
authors.lastname: Ferrannini
mesh_terms: D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D054357:Chemokine CXCL10 / Q000097:blood*; D003378:Counterimmunoelectrophoresis; D003449:Cryoglobulinemia / Q000097:blood* / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012367:RNA, Viral; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha