Ferri C, Monti M, La Civita L, Longombardo G, Greco F, Pasero G, Gentilini P, Bombardieri S, Zignego A L
Istituto Patologia Medica I, University of Pisa, Italy.
Blood. 1993 Dec 15;82(12):3701-4.
A striking association between hepatitis C virus (HCV) infection and mixed cryoglobulinemia (MC) has been shown; thus, HCV seems to play an important etiopathogenetic role in this lymphoproliferative disorder. Because HCV is both a hepatotropic and lymphotropic virus, this study aimed to investigate the prevalence of HCV infection of peripheral blood mononuclear cells (PBMCs) in a series of 16 patients with type II (IgMk) MC. Antibodies against HCV were detected by commercially available kits (Second Generation Chiron enzyme-linked immunosorbent assay [ELISA] and recombinant-based immunoblot assay [RIBA]), and the presence of HCV RNA was evaluated in both sera and isolated PBMCs using the polymerase chain reaction technique. A previous exposure to HCV was shown by ELISA and confirmed by RIBA in all cases (100%). Moreover, HCV RNA was present in the sera of 8 of 16 patients (50%), whereas its frequency markedly increased (13 of 16 [81%]) when genomic sequences were detected in peripheral lymphocytes. HCV RNA was never detected in the PBMCs of 20 control subjects. These findings showed that HCV infection, alone or in combination with other factors, may be responsible for the clonal B-cell expansion underlying the systemic manifestations of MC, and may explain the appearance of a malignant non-Hodgkin's lymphoma in some subjects.
丙型肝炎病毒（HCV）感染与混合性冷球蛋白血症（MC）之间存在显著关联；因此，HCV似乎在这种淋巴增殖性疾病中发挥重要的病因学作用。由于HCV既是嗜肝病毒又是嗜淋巴细胞病毒，本研究旨在调查16例II型（IgMκ）MC患者外周血单个核细胞（PBMC）中HCV感染的患病率。使用市售试剂盒（第二代Chiron酶联免疫吸附测定法[ELISA]和基于重组的免疫印迹测定法[RIBA]）检测抗HCV抗体，并使用聚合酶链反应技术评估血清和分离的PBMC中HCV RNA的存在情况。所有病例（100%）通过ELISA显示既往有HCV暴露，并经RIBA证实。此外，16例患者中有8例（50%）血清中存在HCV RNA，而当在外周淋巴细胞中检测到基因组序列时，其频率显著增加（16例中的13例[81%]）。在20名对照受试者的PBMC中从未检测到HCV RNA。这些发现表明，HCV感染单独或与其他因素共同作用，可能是MC全身表现背后克隆性B细胞扩增的原因，并可能解释一些患者出现恶性非霍奇金淋巴瘤的现象。
