Clinical and pathogenetic value of immune disruptions in manifestation of mixed cryoglobulinemia in patients with chronic hepatitis C

Authors

  • O. O. Furyk Zaporizhzhia State Medical University, Ukraine,
  • Yu. Yu. Riabokon Zaporizhzhia State Medical University, Ukraine,
  • E. V. Riabokon Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.02.124945

Keywords:

cryoglobulinemia, chronic hepatitis C

Abstract

Objective – to discover role of immune disorders in clinical manifestations formation of mixed cryoglobulinemia in patients with CHC.

Material and methods. 214 patients with CHC were included in the study. The conducted research on frequency of detection and quantitative content of non-organ-specific autoantibodies and circulated immune complexes in reference to presence and degree of the mixed cryoglobulinemia manifestation. 

Results. It was found that spectrum of autoantibodies was extended in patients with CHC in case of emergence of signs of the mixed cryoglobulinemia. In case of presence of clinical signs of hemorrhagic cryoglobulinemia vasculitis formation.

Frequency of IgG cardiolipin detection was 82.1 % in patients with symptoms of Meltzer's triad. RF-IgM in 100 % exceeded this index in patients of other groups (P < 0.01). RF-IgM and RF-IgG quantitative content in the blood serum was the highest (P < 0.01) in patients with CHC and presence of the mixed cryoglobulinemia manifestation in comparison with the patients who had no clinical and biochemical signs or had only biochemical signs of the mixed cryoglobulinemia. Level of IgM and IgG cardiolipin were the highest on condition of hemorrhagic cryoglobulinemia vasculitis (P < 0.01). Progressing of the mixed cryoglobulinemia manifestation was combined with the enlarging (P < 0.01) of CIC quantitative content which correlated with RF-IgM (r=+ 0.36, P < 0.05), IgM cardiolipin (r = +0.38, P < 0.05) and IgG cardiolipin (r = +0.45, P < 0.05).

Conclusions. Frequency of detection and quantity of RF-IgM and RF-IgG, IgM cardiolipin and IgG cardiolipin in patients with CHC increases in case of emergence and progressing of the mixed cryoglobulinemia. Increase of non-organ-specific autoantibodies and rise of its quantitative content in patients with CHC in case of emergence and progressing of clinical and biochemical signs of the mixed cryoglobulinemia combines with the rise of CIC in the blood serum which correlates with RF-IgM and RF-IgG, IgM and IgG cardiolipin.

References

Marcellin, P., & Asselah, T. (2014). Viral hepatitis: Impressive advances but still a long way to eradication of the disease. Liver International, 34, 1–3. doi: 10.1111/liv.12422.

Lee, M., Yang, H., Lu, S., Jen, C., You, S., Wang, L., et al. (2012). Chronic Hepatitis C Virus Infection Increases Mortality From Hepatic and Extrahepatic Diseases: A Community-Based Long-Term Prospective Study. Journal of Infectious Diseases, 206(4), 469–477. doi: 10.1093/infdis/jis385.

Negro, F., Forton, D., Craxì, A., Sulkowski, M., Feld, J., & Manns, M. (2015). Extrahepatic Morbidity and Mortality of Chronic Hepatitis C. Gastroenterology, 149(6), 1345–1360. doi: 10.1053/j.gastro.2015.08.035.

Ramos-Casals, M., Stone, J., Cid, M., & Bosch, X. (2012). The cryoglobulinaemias. The Lancet, 379(9813), 348–360. doi: 10.1016/S0140-6736(11)60242-0.

Doi, H., Iyer, T., Carpenter, E., Li, H., Chang, K., Vonderheide, R., & Kaplan, D. (2012). Dysfunctional B-cell activation in cirrhosis resulting from hepatitis C infection associated with disappearance of CD27-Positive B-cell population. Hepatology, 55(3), 709–719. doi: 10.1002/hep.24689.

Holz, L., Yoon, J., Raghuraman, S., Moir, S., Sneller, M., & Rehermann, B. (2012). B cell homeostasis in chronic hepatitis C virus-related mixed cryoglobulinemia is maintained through naïve B cell apoptosis. Hepatology, 56(5), 1602–1610. doi: 10.1002/hep.25821.

Sautto, G., Mancini, N., Clementi, M., & Burioni, R. (2012). Molecular Signatures of Hepatitis C Virus (HCV)-Induced Type II Mixed Cryoglobulinemia (MCII). Viruses, 4(11), 2924–2944. doi: 10.3390/v4112924.

Hepatitis Cacoub, P., Desbois, A., Isnard-Bagnis, C., Rocatello, D., & Ferri, C. (2016). Hepatitis C virus infection and chronic kidney disease: Time for reappraisal. Journal of Hepatology, 65(1), S82–S94. doi: 10.1016/j.jhep.2016.06.011.

Murator, P., Muratori, L., Verucchi, G., Attard, L., Bianchi, F., & Lenzi, M. (2003). Non--Organ-Specific Autoantibodies in Children with Chronic Hepatitis C: Clinical Significance and Impact on Interferon Treatment. Clinical Infectious Diseases, 37(10), 1320–1326. doi: 10.1086/379018.

Wang, R., Bare, P., De Giorgi, V., Matsuura, K., Salam, K., Grandinetti, T., et al. (2016). Preferential association of hepatitis C virus with CD19+B cells is mediated by complement system. Hepatology, 64(6), 1900–1910. doi: 10.1002/hep.28842.

Chiao, E., Engels, E., Kramer, J., Pietz, K., Henderson, L., Giordano, T., & Landgren, O. (2009). Risk of Immune Thrombocytopenic Purpura and Autoimmune Hemolytic Anemia Among 120 908 US Veterans With Hepatitis C Virus Infection. Archives of Internal Medicine, 169(4), 357–63. doi: 10.1001/archinternmed.2008.576.

Ferri, C., Ramos-Casals, M., Zignego, A., Arcaini, L., Roccatello, D., Antonelli, A., et al. (2016). International diagnostic guidelines for patients with HCV-related extrahepatic manifestations. A multidisciplinary expert statement. Autoimmunity Reviews, 15(12), 1145–1160. doi: 10.1016/j.autrev.2016.09.006.

Sthoeger, Z. M., & Fogel, M. (2010). Anticardiolipin autoantibodies in serum semples and cryoglobulins of patients with chronic hepatitis C infection. Ann. Rheum. Dis, 59, 483–486.

Ferri, C., Giuggioli, D., Cassato, M., Sebastiani, M., Mascia, M. T., & Zignego, A. L. (2003). HCV-related cryoglobulinemia vasculitis: an update on its etiopathogenesis and therapeutic strategies. Clin. Exp. Rheumatol., 21, 78–84.

Cacoub, P., Desbois, A., Isnard-Bagnis, C., Rocatello, D., & Ferri, C. (2016). Hepatitis C virus infection and chronic kidney disease: Time for reappraisal. Journal of Hepatology, 65(1), S82–S94. doi: 10.1016/j.jhep.2016.06.011.

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How to Cite

1.
Furyk OO, Riabokon YY, Riabokon EV. Clinical and pathogenetic value of immune disruptions in manifestation of mixed cryoglobulinemia in patients with chronic hepatitis C. Zaporozhye Medical Journal [Internet]. 2018Mar.7 [cited 2024Jul.23];(2). Available from: http://zmj.zsmu.edu.ua/article/view/124945

Issue

No. 2 (2018)

Section

Original research

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