丙型肝炎病毒阳性患者的 II 型和 III 型混合冷球蛋白血症的不同生化模式。
Different biochemical patterns in type II and type III mixed cryoglobulinemia in HCV positive patients.
机构信息
Department of Diagnostic Imaging and Laboratory Medicine, Fondazione Policlinico Universitario Agostino Gemelli - Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Laboratory Medicine - Madre Giuseppina Vannini Hospital, Rome, Italy.
出版信息
Dig Liver Dis. 2018 Sep;50(9):938-943. doi: 10.1016/j.dld.2018.03.028. Epub 2018 Apr 4.
BACKGROUND
Reversible cryoprecipitability of proteins is observed as a concomitant feature of immune complex formation. Mixed cryoglobulinemia (MC) is systemic vasculitis, associated with mixed IgM and IgG cryoglobulins (CGs) showing rheumatoid factor (RF) activity. It is frequently associated with hepatitis C virus (HCV). This study investigates the presence of IgG RF and anti-nuclear antibodies (ANA) in cryoprecipitates of patients with type III and type II MC, to understand the biochemical patterns associated with different types of MC to a greater degree.
METHODS
Sera from 70 HCV untreated patients with type III or type II MC were tested by immunofixation for IgG3 and through ELISA for IgG RF. Cryoprecipitates were analysed for ANA by indirect immunofluorescence to identify specific patterns.
RESULTS
After stratification according to MC type, the ANA patterns between type II and type III MC were statistically different. IgG3 levels and IgG-RF positivity were significantly higher in type III cryoprecipitate. We observed a higher positivity of IgG3 and a significant difference between the liver fibrosis stage, ANA and IgG-RF in the cryoprecipitate.
CONCLUSION
Results show a combination of biochemical markers and autoantibodies associated to mixed cryoglobulinemia; these findings could be further investigated in order to ascertain their usefulness in assessing the risk for the development of mixed cryoglobulinemia.
背景
免疫复合物形成时会出现蛋白质可逆的沉淀现象。混合性冷球蛋白血症（MC）是一种系统性血管炎，与混合 IgM 和 IgG 冷球蛋白（CG）有关，这些冷球蛋白具有类风湿因子（RF）活性。它常与丙型肝炎病毒（HCV）有关。本研究调查了 III 型和 II 型 MC 患者冷沉淀物中 IgG RF 和抗核抗体（ANA）的存在，以更深入地了解与不同类型 MC 相关的生化模式。
方法
通过免疫固定法检测未经治疗的 70 例 HCV 阳性 III 型或 II 型 MC 患者血清中的 IgG3，并通过 ELISA 检测 IgG RF。通过间接免疫荧光法分析冷沉淀物中的 ANA，以确定特定模式。
结果
根据 MC 类型进行分层后，II 型和 III 型 MC 之间的 ANA 模式存在统计学差异。III 型冷沉淀物中的 IgG3 水平和 IgG-RF 阳性率明显更高。我们观察到 IgG3 的阳性率更高，并且在冷沉淀物中肝纤维化分期、ANA 和 IgG-RF 之间存在显著差异。
结论
结果显示出与混合性冷球蛋白血症相关的生化标志物和自身抗体的组合；这些发现可以进一步研究，以确定它们在评估混合性冷球蛋白血症发展风险方面的有用性。
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