Pietrogrande M, Corona M, Milani S, Rosti A, Ramella M, Tordato G
Cattedra di Medicina Interna, Istituto di Scienze Biomediche, Ospedale San Paolo, University of Milan, Italy.
Clin Exp Rheumatol. 1995 Nov-Dec;13 Suppl 13:S109-13.
The authors examine the relationship between the presence of hepatitis C virus (HCV) and anti-HCV antibodies, rheumatoid factor (RF) activity, the level of complement, and the cryocrit in the sera of patients affected by essential mixed cryoglobulinemia (EMC). In addition, the authors evaluate the circulating B-CD5 positive lymphocytes, believed to be RF producers in the blood of EMC patients.
Clinical and laboratory data on 219 cases of EMC were collected from five centers of the GISC (Italian Group for the Study of Cryoglobulinemias). Statistical analyses of these data were carried out with the aim of evidentiating significant relationships, in order to shed light on the mechanism of cryoprecipitation.
The cryocrit was higher in anti-HCV negative and in HCV-RNA positive sera. The titers of RF activity were significantly higher in anti-HCV negative sera. A linear correlation between RF activity and the cryocrit was observed for HCV-RNA positive cases (r = 0.416), this correlation being highest in the patients who were HCV-RNA positive and anti-HCV negative (0.709). Type III EMC were more reactive than type II against the non-structural antigens of HCV, particularly 5-1-1 and C-22. There were more circulating B lymphocytes sharing membrane antigen CD5 in EMC than in the blood of normals or patients with HCV-related chronic hepatitis. Levels of circulating B-CD5 correlated with serum RF activity (r = 0.677), especially in sera from anti-C-100 negative patients (p = 0.991).
The data strongly suggest that the level of the cryoprecipitate is a function of both the HCV-RNA in the serum and the RF activity. Antibody specificity against HCV probably influences the density of the cryoprecipitate.
作者研究了丙型肝炎病毒（HCV）及其抗体、类风湿因子（RF）活性、补体水平以及冷球蛋白血症（EMC）患者血清冷沉淀比容之间的关系。此外，作者还评估了循环B-CD5阳性淋巴细胞，该细胞被认为是EMC患者血液中RF的产生细胞。
从意大利冷球蛋白血症研究小组（GISC）的五个中心收集了219例EMC患者的临床和实验室数据。对这些数据进行统计分析，旨在揭示显著关系，以阐明冷沉淀的机制。
抗HCV阴性且HCV-RNA阳性的血清中冷沉淀比容更高。抗HCV阴性血清中RF活性的滴度显著更高。在HCV-RNA阳性病例中观察到RF活性与冷沉淀比容之间存在线性相关性（r = 0.416），这种相关性在HCV-RNA阳性且抗HCV阴性的患者中最高（0.709）。III型EMC对HCV的非结构抗原，特别是5-1-1和C-22的反应性比II型更强。与正常人和HCV相关慢性肝炎患者的血液相比，EMC患者循环中共享膜抗原CD5的B淋巴细胞更多。循环B-CD5水平与血清RF活性相关（r = 0.677），尤其是在抗C-100阴性患者的血清中（p = 0.991）。
数据强烈表明，冷沉淀物的水平是血清中HCV-RNA和RF活性的函数。针对HCV的抗体特异性可能影响冷沉淀物的密度。
