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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.
AuthorsMartha Minopetrou, Emilia Hadziyannis, Melanie Deutsch, Maria Tampaki, Asimina Georgiadou, Eleni Dimopoulou, Dimitrios Vassilopoulos, John Koskinas
JournalClinical and vaccine immunology : CVI (Clin Vaccine Immunol) Vol. 20 Issue 5 Pg. 698-703 (May 2013) ISSN: 1556-679X [Electronic] United States
PMID23467778 (Publication Type: Journal Article)
Chemical References
  • Cryoglobulins
  • Hepatitis C Antibodies
  • Immunoglobulin G
  • Immunoglobulin M
  • NS3 protein, flavivirus
  • NS4 protein, hepatitis C virus
  • Viral Core Proteins
  • Viral Nonstructural Proteins
  • Serine Endopeptidases
  • RNA Helicases
Topics
  • Adult
  • Aged
  • Cryoglobulinemia
  • Cryoglobulins (analysis)
  • Female
  • Hepacivirus (immunology)
  • Hepatitis C Antibodies (blood, immunology)
  • Hepatitis C, Chronic (blood, immunology)
  • Humans
  • Immunoglobulin G (blood, immunology)
  • Immunoglobulin M (blood, immunology)
  • Male
  • Middle Aged
  • RNA Helicases (immunology)
  • Serine Endopeptidases (immunology)
  • Viral Core Proteins (immunology)
  • Viral Nonstructural Proteins (immunology)

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