Interrelation of Immunological and Clinic-Morphological Parameters in Patients with Chronic Hepatitis C Depending on Mixed Cryoglobulinemia
Introduction. Mixed cryoglobulinemia is the most common extrahepatic manifestations of chronic HCV-infection. Questions about the role of cytokines and features of liver injury in patients with chronic HCV-infection with mixed cryoglobulinemia are debatable. Objective. To determine the interrelation between changes of immunological parameters (cryoglobulins, interferon-gamma, interleukin‑4) and clinic-morphological parameters in patients with chronic hepatitis C with mixed cryoglobulinemia. Materials and methods. Eighty two patients with chronic hepatitis C were examined. Stage of liver fibrosis was determined by morphological study of hepatic samples. Concentration of interferon-gamma and nterleykin‑4 was determined by enzyme immunoassay. Cryoglobulin level was determined by spectrophotometry. Results. In patients with mixed cryoglobulinemia low levels of interferon gamma and high levels of interleukin‑4 were detected in serum, the correlation between concentration of cryoglobulins and interferon gamma (r = –0.32; p < 0.05) and interleukin‑4 (r = 0.36; p < 0.05) was found. The higher level of mixed cryoglobulins was in patients with liver fibrosis F3–4 (p < 0.05). The greater frequency of clinical signs of cryoglobulinemic syndrome was registered in patients with liver fibrosis F3–4. Increasing concentration of mixed cryoglobulins was associated with the appearance of cryoglobulinemic syndrome symptoms (severe general weakness, skin purpura, Raynaud's syndrome) and their number and the severity of liver fibrosis. Enhanced level of interleukin‑4 is associated with the appearance of general weakness, skin purpura, and severe liver fibrosis. Conclusions. Increased level of mixed cryoglobulins is associated with the appearance of cryoglobulinemic syndrome symptoms, their number and with liver fibrosis severity. Increased interleukin‑4 correlates with the concentration of cryoglobulins, and is associated with the appearance of clinical manifestations cryoglobulinemic syndrome and with liver fibrosis F3–4. To improve the diagnosis course of chronic hepatitis C it is important to determine the concentration of cryoglobulins and interleukin‑4.
Negro F, Forton D, Craxì A et al Extrahepatic morbidity and mortality of chronic hepatitis C. Gastroenterology. 2015; 149(6): 1345-1360.
Jacobson IM, Cacoub P, Maso L Dal.et al. Manifestations of chronic hepatitis C virus infection beyond the liver. Clin Gastroenterol Hepatol. 2010; 8(12):1017-1029.
Cacoub P, Comarmond C, Domont F et al. Extrahepatic manifestations of chronic hepatitis C virus infection. Ther. Adv. Infect. Dis. 2016; 3(1): 3-14.
Cacoub P, Comarmond C, Domont F. et al. Cryoglobulinemia Vasculitis. Am. J. Med. 2015; 128(9): 950-955.
Rosenthal E, Cacoub P. Extrahepatic manifestations in chronic hepatitis C virus carriers. http://www.ncbi.nlm.nih.gov/pubmed/258018902015; 24(4-5); 469-482.
Ryabokon` YuYu. [Autoimmune disorders in patients with chronic hepatitis C with varying degrees of severity mixed cryoglobulinemia]. Bukovy`ns`ky`j medy`chny`j visny`k. 2012; 16; 3 (63): 80-83. Ukrainian.
Ramos-Casals M, Stone JH, Cid MC et al. The cryoglobulinaemias. Lancet. 2012; 379: 348-360.
Malyshko EJu, Konstantinova NA, Semenova EN. [Cryoglobulinemia associated with HCV-infection]. Klinicheskaja medicina. 2001; 1: 9-14. Russian.
Metts J, Carmichael L, Kokor W et al. Hepatitis C: extrahepatic manifestations. F. P. Essent. 2014; 427: 32-35.
Naslednikova IO, Beloborodova EV, Rjazanceva NV. [Immunoregulatory cytokines and chronicity of hepatitis C: Clinical and immunological parallels]. Klinicheskaja medicina. 2005; 9: 40-44. Russian.
Atta AM, Oliveira IS, Sousa GM. Serum cytokine profile in hepatitis C virus carriers presenting cryoglobulinaemia and non-organ-specific autoantibodies. Microb Pathog. 2010; 48 (2): 53-56.
Antonelli A, Ferri C, Ferrari SM. Serum concentrations of interleukin 1beta, CXCL10, and interferon-gamma in mixed cryoglobulinemia associated with hepatitis C infection. J. Rheumatol. 2010; 37 (1): 91-97.
Antonelli A, Fallahi P, Ferrari SM. Chemokine (CXC motif) ligand 9 serum levels in mixed cryoglobulinemia are associated with circulating levels of IFN-γ and TNF-α. Clin. Exp. Rheumatol. 2012; 30(6): 864-870.
Antonelli A, Ferri C, Ferrari SM. High interleukin-6 and tumor necrosis factor-alpha serum levels in hepatitis C infection associated or not with mixed cryoglobulinemia. Clin. Rheumatol. 2009; 28 (10): 1179-1185.
Monteverde A, Ballare M. Limphoproliferation in type II mixed cryoglobulinemia. Clin. Exp. Rheumatol. 1995; 13: 141-147.
Saadoun D, Saadoun D, Asselah T, Resche-Rigon M. Cryoglobulinemia is associated with steatosis and fibrosis in chronic hepatitis C. Hepatology. 2006; 43 (6): 1337-1345.
De Rosa F, Abel G, Agnello V. Observations on cryoglobulin testing: II. The association of oligiclonal mixed cryoglobulinemia with cirrhosis in patients infected with hepatitis C virus. J. Rheumatol. 2009; 36 (9): 1956-1957.
Ignatova TM, Muhin NA,. Serov VV. [HCV-infection and mixed cryoglobulinemia]. Klinicheskaja medicina. 2005; 83(6): 37-43. Russian.
Rjabokon' JuJu. Rol' autoimmunnyh narushenij v razvitii vnepechenochnyh projavlenij hronicheskogo gepatita S. Medicinskie novosti Gruzii. 2013; 4(213): 40-44.
Ito M, Kusunoki H, Yamaguchi K, Ito M. HCV Infection and B-Cell Lymphomagenesis. Adv. Hematol; 2011.
Moroz LV, Romanchuk KJu. [Prediction of pharmacotherapy of chronic hepatitis C, depending on the gene polymorphism IL28B3]. Aktual'naja infektologija. 2014; 3(4): 39-41. Russian.
- There are currently no refbacks.
Copyright (c) 2016 ACTUAL INFECTOLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2017