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Hepatitis C Virus (HCV)-Related Cryoglobulinemia: Cryoglobulin Type and Anti-HCV Profile

机译:丙型肝炎病毒(HCV)相关的冰球蛋白血症:冰球蛋白类型和抗HCV特性

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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.
机译:慢性丙型肝炎(CHC)中的冷球蛋白特性可能对于进一步了解该病的发病机理和治疗具有重要意义。我们的目的是调查丙种球蛋白的类型及其对丙型肝炎患者丙型肝炎病毒(HCV)抗原表位的特异性之间的关系。我们分析了43例HCV相关性冷球蛋白血症患者的样本,其中4例伴有淋巴瘤。对冰球蛋白进行测量,纯化,通过免疫固定电泳进行分型,并通过免疫印迹分析和酶联免疫吸附测定(ELISA)检测IgG和IgM抗HCV抗体。记录临床和其他实验室数据。测试样品的中位冷冻比容水平为6%。在9.3%(4/43)的冷沉淀物中检出I型冰球蛋白,在48.8%(21/43)的冷沉淀物中检出II型冰球蛋白。在92%(23/25)的I型和II型冷沉淀物中发现了IgM单克隆蛋白,主要是IgM(κ)。在41.9%(18/43)的患者中鉴定出III型冰球蛋白,并与血清IgG高水平相关。在II型81.3%(13/16)和III2.3%(12/13)III型球蛋白中,有针对病毒核心区域的IgG反应性。 IgG抗HCV核心阳性冷沉淀的92%和32%分别具有针对NS3和NS4区域的额外特异性。另外,在31%的冷沉淀物中检测到IgM抗HCV抗体。总之,在HCV相关性冷球蛋白血症患者中发现了所有类型的冷球蛋白,其中最常见的是II型。 III型冷冻球蛋白很常见,并且与血清IgG高水平相关。 HCV相关的冷球蛋白显示出IgM(尤其是IgG)抗HCV特异性,主要针对核心和NS3表位。

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