title: Hepatitis C virus (HCV)-related cryoglobulinemia: cryoglobulin type and anti-HCV profile.
abstract: Cryoglobulin characteristics in chronic hepatitis C (CHC) might be of importance for knowing more about the pathogenesis and treatment of the disease. We aimed to investigate the relationship between cryoglobulin types and their specificity against hepatitis C virus (HCV) antigenic epitopes in CHC patients. We analyzed samples from 43 patients with HCV-associated cryoglobulinemia, of whom 4 had concomitant lymphoma. Cryoglobulins were measured, purified, typed by immunofixation electrophoresis, and tested for IgG and IgM anti-HCV antibodies by immunoblot analysis and an enzyme-linked immunosorbent assay (ELISA). Clinical and other laboratory data were recorded. The median cryocrit level of the tested samples was 6%. Type I cryoglobulins were detected in 9.3% (4/43) of the cryoprecipitates, and type II cryoglobulins were detected in 48.8% (21/43) of the cryoprecipitates. IgM monoclonal protein, mainly IgM(κ), was found in 92% (23/25) of type I and II cryoprecipitates. Type III cryoglobulins were identified in 41.9% (18/43) of the patients and were associated with high blood serum IgG levels. In 81.3% (13/16) of type II and 92.3% (12/13) of type III cryoglobulins, there was IgG reactivity against the viral core region. Ninety-two percent and 32% of IgG anti-HCV core-positive cryoprecipitates had additional specificities against the NS3 and NS4 regions, respectively. Also, IgM anti-HCV antibodies were detected in 31% of the cryoprecipitates. In conclusion, all types of cryoglobulins were found in patients with HCV-associated cryoglobulinemia, with type II being the most frequently identified. Type III cryoglobulins were common and were associated with high serum IgG levels. HCV-related cryoglobulins demonstrated IgM, and particularly IgG, anti-HCV specificities, mainly against the core and NS3 epitopes.
authors: Second Academic Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, Athens, Greece.
authors: Martha
authors: M
authors: Minopetrou
authors: Emilia
authors: E
authors: Hadziyannis
authors: Melanie
authors: M
authors: Deutsch
authors: Maria
authors: M
authors: Tampaki
authors: Asimina
authors: A
authors: Georgiadou
authors: Eleni
authors: E
authors: Dimopoulou
authors: Dimitrios
authors: D
authors: Vassilopoulos
authors: John
authors: J
authors: Koskinas
mesh_terms: D000328:Adult; D000368:Aged; D003449:Cryoglobulinemia; D003450:Cryoglobulins / Q000032:analysis*; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D018937:Hepatitis C Antibodies / Q000097:blood* / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D020365:RNA Helicases / Q000276:immunology; D012697:Serine Endopeptidases / Q000276:immunology; D014758:Viral Core Proteins / Q000276:immunology; D017361:Viral Nonstructural Proteins / Q000276:immunology; D043583:Nucleoside-Triphosphatase; D053487:DEAD-box RNA Helicases; D000085242:Viral Proteases
chemical_list: D003450:Cryoglobulins; D018937:Hepatitis C Antibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D020365:RNA Helicases; D012697:Serine Endopeptidases; D014758:Viral Core Proteins; D017361:Viral Nonstructural Proteins; C060028:NS3 protein, flavivirus; D043583:Nucleoside-Triphosphatase; D053487:DEAD-box RNA Helicases; D000085242:Viral Proteases; C093542:NS4 protein, hepatitis C virus