Rheumatology Advance Access originally published online on May 30, 2006
Rheumatology 2007 46(1):37-43; doi:10.1093/rheumatology/kel174
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
B-Lymphocyte stimulator (BLyS) up-regulation in mixed cryoglobulinaemia syndrome and hepatitis-C virus infection
1Division of Rheumatology, DPMSC, School of Medicine, University of Udine, 2Internal Medicine, UCO, University of Trieste, 3Division of Internal Medicine 2, S. Maria degli Angeli Hospital, Pordenone, 4Department of Rheumatology, UCSC, School of Medicine, Catholic University of Rome, Italy and 5Human Genome Sciences, Rockville, MD, USA.
Correspondence to: Prof. S. De Vita, Chief, Clinic of Rheumatology, DPMSC, University of Udine, 33100 Udine, Italy. E-mail: salvatore.devita{at}med.uniud.it
 |
Abstract |
|---|
Objectives. To investigate the role of B-Lymphocyte stimulator (BLyS) in mixed cryoglobulinaemia syndrome (MCsn), a systemic vasculitis associated with a high risk to develop lymphoma, since BLyS up-regulation may favour both autoimmunity and lymphoproliferation.
Methods. BLyS serum levels were analysed by enzyme-linked immunosorbent assay (positive when >0.85 ng/ml) in 66 patients with MCsn, 54 (81.8%) of whom were positive for hepatitis-C virus (HCV) infection. Thirty-three HCV-positive patients without MCsn were also studied. Patients were compared with 48 healthy blood donors (HBDs). BLyS modifications after antiviral therapy were also studied.
Results. A significantly higher frequency of BLyS serum positivity was detected both in MCsn patients and in HCV-positive patients without MCsn (37.9 and 30.3%, respectively) when compared with HBDs (4.2%) (P < 0.0001 vs MCsn and P = 0.0026 vs HCV-positive patients without MCsn, respectively). BLyS appeared significantly higher in MCsn (3.70 ± 2.97 ng/ml) than in HCV-positive patients without MCsn (1.56 ± 0.63 ng/ml; P = 0.0044). BLyS expression did not correlate with rheumatoid factor levels, cryoglobulin levels or definite MCsn-related systemic features. High BLyS levels were significantly associated only with MCsn-related overt lymphoproliferative disorder. Finally, antiviral treatment significantly increased BLyS levels, independently from HCV-RNA negativization. However, BLyS normalization was noticed after both HCV-RNA negativization and suspension of antiviral therapy by preliminary data.
Conclusions. BLyS is up-regulated and may play a pathogenetic role in a fraction of patients with MCsn, similarly to other autoimmune diseases. HCV infection likely represents the early event leading to BLyS up-regulation in this setting. BLyS is up-regulated during antiviral treatment. Overall, these data provide new insights for BLyS and virus-related autoimmunity, lymphoproliferation and possible treatment strategies.
KEY WORDS: BLyS, BAFF, cryoglobulinemia, HCV, rheumatoid arthritis, SLE, Sjögren's syndrome
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  V. De Re, S. De Vita, D. Sansonno, and G. Toffoli Mixed cryoglobulinemia syndrome as an additional autoimmune disorder associated with risk for lymphoma development Blood, June 15, 2008; 111(12): 5760 - 5760. [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Barsoum Hepatitis C virus: from entry to renal injury--facts and potentials Nephrol. Dial. Transplant., July 1, 2007; 22(7): 1840 - 1848. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Sansonno, A. Carbone, V. De Re, and F. Dammacco Hepatitis C virus infection, cryoglobulinaemia, and beyond Rheumatology, April 1, 2007; 46(4): 572 - 578. [Abstract] [Full Text] [PDF]
|
|