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HCV-Induced Cryoglobulinemic Vasculitis: Pathogenesis and Therapeutic Implications

  • Domenico Sansonno
  • Vito Cornacchiulo
  • Franco Dammacco

Summary

Leucocytoclastic vasculitis is the dominant lesion of mixed cryoglobulinemia (MC). The high prevalence of antibodies to hepatitis C virus (HCV) in association with the higher concentration of HCV RNA genomic sequences in the cryoglobulins and analysis of the composition of immune complexes (ICs) suggest a close relation between MC and HCV infection and strongly supports the view that this virus plays a key role in causing vascular damage. Our data indicate that endothelial cells are fully susceptible to infection of HCV, and support the contention that they serve as sufficient targets for the binding of HCV proteins expressed on the cell surface to serum immunoglobulins. The in situ demonstration of IgM RF WA cross-idiotype (XId) adds further evidence that RF of the WA group participates in the development of vasculitis, and probably stabilizes the binding of ICs. Lymphomonocytes may be crucial in the infection of endothelial cells by acting as a circulating viral reservoir. The efficacy of interferon in the treatment of MC, has been shown in more than 50% of patients and includes improvement of cutaneous vasculitis and renal function. However, almost 80% of responders have a clinical and biochemical relapse after treatment withdrawal.

Keywords

Mixed Cryoglobulinemia Membranoproliferative Glomerulonephritis Cutaneous Vasculitis Endothelial Cell Circ Essential Mixed Cryoglobulinemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Domenico Sansonno
    • 1
  • Vito Cornacchiulo
    • 1
  • Franco Dammacco
    • 1
  1. 1.Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical OncologyUniversity of Bari Medical SchoolBariItaly

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