title: Presence of Rheumatoid Factor during Chronic HCV Infection Is Associated with Expansion of Mature Activated Memory B-Cells that Are Hypo-Responsive to B-Cell Receptor Stimulation and Persist during the Early Stage of IFN Free Therapy.
abstract: Approximately half of those with chronic hepatitis C virus (HCV) infection have circulating rheumatoid factor (RF), and a portion of these individuals develop cryoglobulinemic vasculitis. B cell phenotype/function in relation to RF in serum has been unclear. We examined B cell subset distribution, activation state (CD86), cell cycle state (Ki67), and ex-vivo response to BCR, TLR9 and TLR7/8 stimulation, in chronic HCV-infected donors with or without RF, and uninfected donors. Mature-activated B-cells of HCV-infected donors had lower CD86 expression compared to uninfected donors, and in the presence of RF they also showed reduced CD86 expression in response to BCR and TLR9 stimulation. Additionally, mature activated memory B cells of HCV RF+ donors less commonly expressed Ki67+ than HCV RF- donors, and did not proliferate as well in response to BCR stimulation. Proportions of mature-activated B cells were enhanced, while naïve B-cells were lower in the peripheral blood of HCV-RF+ compared to RF- and uninfected donors. None of these parameters normalize by week 8 of IFN free direct acting antiviral (DAA) therapy in HCV RF+ donors, while in RF- donors, mature activated B cell proportions did normalize. These data indicate that while chronic HCV infection alone results in a lower state of activation in mature activated memory B cells, the presence of RF in serum is associated with a more pronounced state of unresponsiveness and an overrepresentation of these B cells in the blood. This phenotype persists at least during the early time window after removal of HCV from the host.
authors.affiliation: Department of Pathology, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Elane
authors.initials: E
authors.lastname: Reyes-Avilés
authors.affiliation: Divisions of Infectious and Rheumatic Diseases, Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Lenche
authors.initials: L
authors.lastname: Kostadinova
authors.affiliation: Department of Medicine, VA Medical Center, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Anne
authors.initials: A
authors.lastname: Rusterholtz
authors.affiliation: Divisions of Infectious and Rheumatic Diseases, Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Angelica
authors.initials: A
authors.lastname: Cruz-Lebrón
authors.affiliation: Division of Gastroenterology, Veterans Administration Medical Center, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Yngve
authors.initials: Y
authors.lastname: Falck-Ytter
authors.affiliation: Department of Pathology, Case Western Reserve University, Cleveland Ohio, United States of America.|Divisions of Infectious and Rheumatic Diseases, Department of Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland Ohio, United States of America.|Department of Medicine, VA Medical Center, Case Western Reserve University, Cleveland Ohio, United States of America.
authors.forename: Donald D
authors.initials: DD
authors.lastname: Anthony
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000276:immunology*; D003449:Cryoglobulinemia / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011947:Receptors, Antigen, B-Cell / Q000378:metabolism; D012217:Rheumatoid Factor / Q000378:metabolism
chemical_list: D000998:Antiviral Agents; D011947:Receptors, Antigen, B-Cell; D012217:Rheumatoid Factor