Interactive Impacts from Hepatitis C Virus Infection and Mixed Cryoglobulinemia on Complement Levels

Published on Jul 1, 2021in Digestive Diseases and Sciences3.199
路 DOI :10.1007/S10620-020-06507-9
Ming-Ling Chang13
Estimated H-index: 13
(CGU: Chang Gung University),
Jing-Hong Hu4
Estimated H-index: 4
(Memorial Hospital of South Bend)
+ 4 AuthorsRong-Nan Chien21
Estimated H-index: 21
(CGU: Chang Gung University)
Sources
Abstract
How hepatitis C virus (HCV) infection and mixed cryoglobulinemia interactively affect complement levels remains elusive, and we aimed to elucidate it. A prospective cohort study of 678 consecutive chronic HCV-infected (CHC) patients was conducted. Of 678, 438 had completed a course of anti-HCV therapy and 362 had achieved a sustained virological response (SVR). The baseline and 24-week post-therapy variables including complement levels and mixed cryoglobulinemia status were surveyed. At baseline, lower complement component 3 (C3) and component 4 (C4) levels were noted in patients with than those without mixed cryoglobulinemia. The differences between pre-therapy (in 678 CHC patients) and 24-week post-therapy (in 362 SVR patients) factors associated with C3 levels were interferon 位3 (IFNL3) genotype, triglycerides, cirrhosis, and estimated glomerular filtration rate; the different associations with C4 levels were cirrhosis, sex and high sensitivity C-reactive protein. Compared with baseline, SVR patients without pre- and post-therapy mixed cryoglobulinemia had increased C3 levels, and SVR patients with pre-therapy mixed cryoglobulinemia had increased C4 levels. Lower C3 levels were noted in SVR patients with than those without post-therapy mixed cryoglobulinemia. HCV might affect C3 levels through IFNL3 genotype, triglycerides, cirrhosis, and renal function; and affect C4 with a link to sex, inflammation, and cirrhosis. That C3 levels decreased in CHC patients without mixed cryoglobulinemia or in SVR patients with post-therapy mixed cryoglobulinemia, and C4 levels decreased in CHC patients with mixed cryoglobulinemia, suggested that mixed cryoglobulinemia and HCV infection antagonistically and synergistically decrease C3 and C4 levels, respectively.
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1 Author (Chun Zhang)
References37
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#1Ya-Ting Cheng (Memorial Hospital of South Bend)H-Index: 1
#2Jur-Shan Cheng (CGU: Chang Gung University)H-Index: 1
Last. Ming-Ling Chang (CGU: Chang Gung University)H-Index: 13
view all 6 authors...
Abstract Objectives The prevalence and factors of hepatitis C virus (HCV) -associated mixed cryoglobulinaemia in Asia remain elusive, and we aimed to investigate these topics. Methods An 8-year prospective cohort study was conducted in 678 consecutive Taiwanese individuals with chronic HCV infection (438 completed an anti-HCV therapy course). Results Of 678 individuals, 437 (64.5%) had mixed cryoglobulinaemia and 20 (2.9%) had mixed cryoglobulinaemic syndrome. At baseline, IgM (cut-off >122 mg/d...
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#1Kuan鈥怌hieh Lee (Memorial Hospital of South Bend)H-Index: 2
#2Ya-Ting Cheng (Memorial Hospital of South Bend)H-Index: 3
Last. Ming-Ling Chang (CGU: Chang Gung University)H-Index: 13
view all 7 authors...
BACKGROUND: The prevalence and associations of mixed cryoglobulinemia (MC) in patients with spontaneous clearance of hepatitis C virus (HCV) remain elusive. MATERIALS AND METHODS: A 13-year prospective cohort study of patients with spontaneous HCV clearance was conducted in a tertiary care centre. Baseline characteristics, incident cardiovascular and neurologic events and cancers were analysed. RESULTS: Of 104 consecutive patients (mean age: 54.08 years old; females: 71 [68%]), 37 (34.6%) had MC...
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#1Ahmed El-Shamy (California Northstate University College of Pharmacy)H-Index: 12
#2Andrea D. Branch (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 38
Last. Peter D. Gorevic (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 47
view all 4 authors...
The complement system bridges innate and adaptive immunity against microbial infections, with viral infection being a major trigger. Activation of the classical, alternative, and lectin pathways have been reported in chronic hepatitis C Virus (HCV) infection and/or cryoglobulinemia. HCV infection leads to dysregulation of complement-mediated immune responses. Clinical and experimental evidence support involvement of complement in intra- and extrahepatic manifestations of HCV infection such as li...
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#1Su-Wei Chang (CGU: Chang Gung University)H-Index: 22
#2Mei-Ling Cheng (CGU: Chang Gung University)H-Index: 29
Last. Ming-Ling Chang (CGU: Chang Gung University)H-Index: 10
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Background How hepatitis C virus (HCV)鈥揳ssociated lipid metabolic alterations recover after sustained virological response (SVR) remains elusive. Objective The aforementioned recovery pattern was investigated. Methods In a prospective cohort study of 438 chronic hepatitis C (CHC) patients with SVR after anti-HCV therapy, 164 sex- and age-matched genotype I (G1) and G2 patients underwent paired-serum liquid chromatography-tandem mass spectrometry analyses before and 24 weeks after therapy. Subjec...
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#1Joel S. Emery (UHN: University Health Network)H-Index: 2
#2Magdalena Kuczynski (UHN: University Health Network)H-Index: 1
Last. Jordan J. Feld (UHN: University Health Network)H-Index: 65
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Efficacy and Safety of Direct Acting Antivirals for the Treatment of Mixed Cryoglobulinemia
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#1Martina Del Padre (Sapienza University of Rome)H-Index: 5
#2Laura Todi (Sapienza University of Rome)H-Index: 9
Last. Marcella Visentini (Sapienza University of Rome)H-Index: 17
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Intra-tumor heterogeneity is a hallmark of B acute lymphoblastic leukemia (B-ALL) favoring dissociated treatment responses, clonal evolution and disease progression. Heterogeneity at the genetic level has been widely described, but prospective isolation of functionally relevant, rare blast subpopulation within the B-ALL bulk remains challenging. We have found that all human adult B-ALL we tested (n=11) contained up to 4 subpopulations differing in the expression level of a stem cell microRNA, mi...
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#1Predrag Ostojic (University of Belgrade)H-Index: 10
#2Ivan R Jeremic (University of Belgrade)H-Index: 2
: Cryoglobulinemia is thought to be a rare condition. It may be an isolated disorder or secondary to a particular disease. According to immunoglobulin composition, cryoglobulinemia is classified into three types. In mixed cryoglobulinemia (types II and III), vascular deposition of cryoglobulin-containing immune complexes and complement may induce a clinical syndrome, characterized by systemic vasculitis and inflammation - cryoglobulinemic vasculitis (CryoVas). Most common clinical manifestations...
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#1Rosalie Lubbers (LUMC: Leiden University Medical Center)H-Index: 5
#2M. F. van Essen (LUMC: Leiden University Medical Center)H-Index: 1
Last. Leendert A. Trouw (LUMC: Leiden University Medical Center)H-Index: 62
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Summary The complement system is an important part of the innate immune defence. It contributes not only to local inflammation, removal and killing of pathogens, but it also assists in shaping of the adaptive immune response. Besides a role in inflammation, complement is also involved in physiological processes such as waste disposal and developmental programmes. The complement system comprises several soluble and membrane-bound proteins. The bulk of the soluble proteins is produced mainly by th...
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#1Ming-Ling Chang (CGU: Chang Gung University)H-Index: 10
#2Mei-Ling Cheng (CGU: Chang Gung University)H-Index: 29
Last. Ming-Shi Shiao (CGU: Chang Gung University)H-Index: 31
view all 7 authors...
Recovery of amino acid (AA) metabolism and the associated clinical implications in chronic hepatitis C (CHC) patients with sustained virological response (SVR) following anti-hepatitis C virus (HCV) therapy remains elusive. A prospective cohort study was conducted on 222 CHC patients with SVR. Eighty-two age-matched male genotype 1 (G1) and G2 patients underwent paired serum metabolomics analyses with liquid chromatography鈥搕andem mass spectrometry to examine AAs before and 24 weeks after anti-HC...
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#1Ming-Ling Chang (Memorial Hospital of South Bend)H-Index: 10
#2Chia-Jung Kuo (Memorial Hospital of South Bend)H-Index: 1
Last. Cheng-Tang Chiu (Memorial Hospital of South Bend)H-Index: 26
view all 5 authors...
BACKGROUND: The association between leptin and complement in hepatitis C virus (HCV) infection remains unknown. METHODS: A prospective study was conducted including 474 (250 genotype 1, 224 genotype 2) consecutive chronic hepatitis C (CHC) patients who had completed an anti-HCV therapy course and undergone pre-therapy and 24-week post-therapy assessments of interferon 位3-rs12979860 and HCV RNA/genotypes, anthropometric measurements, metabolic and liver profiles, and complement component 3 (C3), ...
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