Objective
Hepatitis C virus (HCV) is associated with B cell lymphoproliferative disorders, including mixed cryoglobulinemia (MC) vasculitis and B cell non-Hodgkin’s lymphoma. The expansion of clonal and autoreactive rheumatoid factor–bearing CD21−/low marginal zone (MZ) B cells was demonstrated in patients with HCV-associated MC vasculitis. Fc receptor–like (FCRL) proteins comprise a family of immunoregulatory proteins preferentially expressed on B lineage cells. The goal of this study was to investigate the expression of FCRL proteins 1–5 on B cells from patients with HCV-associated MC vasculitis.
Methods
Expression of FCRL proteins 1–5 was assessed by flow cytometry on B cells from 15 HCV-infected patients with type II MC (7 of whom had B cell non-Hodgkin’s lymphoma), 20 HCV-infected patients without MC, and 20 healthy donors. To evaluate FCRL-5 as an immunotherapy target in HCV-associated MC vasculitis, 2 anti–FCRL-5 recombinant immunotoxins were produced using anti–FCRL-5 monoclonal antibodies and Pseudomonas exotoxin.
Results
Expression of FCRLs 2, 3, and 5 was markedly increased while expression of FCRL-1 was decreased on clonal CD21−/low MZ B cells, as compared with other B cell subsets, from HCV-infected patients and healthy donors. However, there was no difference in the pattern of FCRL expression between HCV-MC patients with lymphoma and those without lymphoma. The anti–FCRL-5 immunotoxins showed specific cytotoxicity against FCRL-5–expressing clonal CD21−/low MZ B cells isolated from HCV-infected patients as well as FCRL-5–transfected cell lines. No cytotoxicity against T cells or conventional B cells was observed.
Conclusion
These findings suggest that FCRL-5–targeting therapies could be a specific treatment for HCV-associated MC vasculitis and other FCRL-5–positive autoimmune B cell disorders.