Open AccessCryoglobulins: putative effectors of adaptive immune response
Author(s) -
Umberto Basile,
Cecilia Napodano,
Mariapaola Marino,
Francesca Gulli,
Stefania Colantuono,
Milvia Casato,
Krizia Pocino,
Valerio Basile,
Laura Todi,
Gian Ludovico Rapaccini,
Marcella Visentini
Publication year - 2021
Publication title -
clinical and experimental rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.184
H-Index - 95
eISSN - 1593-098X
pISSN - 0392-856X
DOI - 10.55563/clinexprheumatol/keip4u
Subject(s) - immunology , cryoglobulins , rheumatoid factor , medicine , autoantibody , immune system , antibody , monoclonal , pathogenesis , cryoglobulinemia , monoclonal antibody , hepatitis c virus , vasculitis , virus , virology , pathology , disease
Cryoglobulinaemia consists of circulating monoclonal and/or polyclonal immunoglobulins with rheumatoid factor (RF) activity that precipitate at temperatures <37°C. Cryoglobulinaemic syndrome, characterised by clinical signs of systemic vasculitis, is associated with chronic infection of hepatitis C virus (HCV) and might evolve in B-cell malignancies. In about one third of all HCV infection cases, serum autoantibodies are commonly found. This is probably due directly to the transformation of infected B cells but, also, indirectly, to the viral chronic stimulation of a pool of autoreactive B cells. The pattern of IgG subclasses seems to contribute to the worsening progression of HCV infection into lymphoproliferative and/or autoimmune diseases. Many evidences showed that B cells circulating in patients with HCV-associated mixed cryoglobulinaemia (MC) are profoundly abnormal; moreover, in most of cases, normal B cells are replaced by expanded clonal B cells characterized by the low expression of CD21. After viral eradication, these cells persist in circulation and their occurrence does not correlate with serum cryoglobulins nor with vasculitis response or relapse. It is probably due to the persistence of monoclonal B cells producing RF, that in course of MC can be reactivated by circulating immune complexes, highly produced during infections or tumours. Here, we aimed to review current literature focusing the pathogenesis of MC referring to specificity and immunochemical characteristics of the immunoglobulins involved in cryoprecipitation.