Antibodies to hepatitis C virus in autoimmune liver disease: evidence for geographical heterogeneity

Lenzi, Marco; Ballardini, G.; Bianchi, Francesco; Johnson, Philip J.; McFarlane, Ian G.; Smith, Heather M.; McFarlane, Barbara M.; Bridger, C.; Williams, Roger; Vergani, Diego

doi:10.1016/0140-6736(91)90418-o

Cited by 196 publications

(69 citation statements)

References 21 publications

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“…2 The high HCV mutation rate readily generates variants that contribute to establishing the persistent infection. 3 HCV is known to cause a variety of systemic immunologic reactions or abnormalities such as circulating immune complexes, 4 autoantibodies, 5,6 and autoimmune manifestations. [7][8][9][10] Although the liver is considered the primary site of HCV replication with convincing evidence, 11,12 systemic or extrahepetic immune reactions, as well as intrahepatic responses, can be induced in the course of chronic infection.…”

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confidence: 99%

Functional B-cell response in intrahepatic lymphoid follicles in chronic hepatitis C

et al. 1999

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Hepatitis C virus (HCV) is recognized as a major causative agent of parenterally transmittable non-A, non-B hepatitis. 1 HCV infection often persists for a long time and leads to chronic liver diseases; at least half of the HCV cases develop into chronic hepatitis, and 10% to 20% of cases develop into cirrhosis. 2 The high HCV mutation rate readily generates variants that contribute to establishing the persistent infection. 3

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confidence: 99%

Functional B-cell response in intrahepatic lymphoid follicles in chronic hepatitis C

et al. 1999

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“…14,15 ASGP-R has been identified as a target antigen for both humoral and cellular immune response in inflammatory liver diseases. 16 These antibodies show the highest incidence in type I autoimmune hepatitis, but are frequently detectable also in other forms of chronic hepatitis, such as hepatitis B 17 and C, 18 and primary biliary cirrhosis. 19 However, the pathogenetic role of circulating ASGP-R autoantibodies for liver damage during the course of autoimmune hepatitis remains to be elucidated.…”

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confidence: 99%

Asialoglycoprotein receptor facilitates hemolysis in patients with alcoholic liver cirrhosis

et al. 2004

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Hemolysis in patients with advanced alcoholic liver disease is a common clinical problem and indicates an unfavorable prognosis. In many cases, the etiology of the hemolysis remains unknown. We observed three patients with alcoholic liver disease, suffering from severe hemolytic anemia, requiring multiple blood transfusions. Steroid therapy was ineffective and two of the patients died. All patients had a soluble variant of the human asialoglycoprotein receptor (s-ASGP-R) in their serum, as well as high titers of autoantibodies against this receptor (anti-ASGP-R). Consecutively, examination of 60 patients with alcoholic liver disease revealed a high incidence for s-ASGP-R (36%) and anti-ASGP-R (27%) in patients with alcoholic liver cirrhosis (ALC) compared to patients with cirrhosis due to viral hepatitis. The potential etiology of hemolysis was studied in vitro on erythrocytes from patients with ALC and from healthy donors. Isolated ASGP-R but not anti-ASGP-R bound to the surface of erythrocytes preferentially of blood group A1 and caused dose-dependent agglutination and hemolysis, while this phenomenon was much lower using erythrocytes of the blood group B and almost absent with blood group O-erythrocytes. Furthermore, agglutination and hemolysis only occurred in erythrocytes from ALC-patients or after the pretreatment of cells with neuraminidase. ASGP-R induced agglutination and hemolysis was blocked by the competitive ASGP-R inhibitor asialofetuin. In conclusion, our results indicate a new, non-immunological mechanism for hemolysis in patients with alcoholic liver disease, mediated through agglutination by a soluble variant of the human asialoglycoprotein receptor and mechanical shear stress.

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“…As observed for HCV infection, the prevalence of other virus-related MC seems to show a variable prevalence among patient's series from different geographical areas [86]. Moreover, a number of clinicoepidemiological studies revealed a heterogeneous distribution of different HCV-related extra hepatic manifestations, including some autoimmune disorders such as 'primary' Sjogren's syndrome [87][88][89][90][91][92][93][94][95][96][97][98].…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Cryoglobulinemic syndrome can represent a crossroads between some autoimmune diseases (autoimmune hepatitis, Sjögren's syndrome, polyarthritis, glomerulonephritis, thyroiditis, type 2 diabetes, etc.) and malignancies (B-cell lymphomas, hepatocellular carcinoma) [3,11,12,25,28,[87][88][89][90][91][92][93][94][95][96][97][98]. It is possible to observe in Differential diagnosis between mixed cryoglobulinemia and other autoimmune-lymphoproliferative disorders in the setting of HCV infection the same patient a slow progression from mild HCV-associated hepatitis to various extrahepatic manifestations (arthralgias, sicca syndrome, Raynaud's phenomenon, RF positivity, etc.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Cryoglobulinemic syndrome may share a number of etiopathogenetic events and clinical features with both autoimmune diseases such as autoimmune hepatitis, Sjö-gren's syndrome, and polyarthritis, and B-cell lymphomas [3,11,12,25,28,[85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100]. Therefore, a differential diagnosis should be carefully done in all patients with MC syndrome (Fig.…”

Section: Etiopathogenesismentioning

confidence: 99%

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Mixed cryoglobulinemia

Andréu¹,

Hernández²,

Rodríguez³

et al.

SpringerReference

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Antibodies to hepatitis C virus in autoimmune liver disease: evidence for geographical heterogeneity

Cited by 196 publications

References 21 publications

Functional B-cell response in intrahepatic lymphoid follicles in chronic hepatitis C

Functional B-cell response in intrahepatic lymphoid follicles in chronic hepatitis C

Asialoglycoprotein receptor facilitates hemolysis in patients with alcoholic liver cirrhosis

Mixed cryoglobulinemia

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