Hepatitis C virus-related mixed cryoglobulinemia: Is genetics to blame?
Hepatitis C virus-related mixed cryoglobulinemia: Is genetics to blame?
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DOI：
10.3748/wjg.v19.i47.8910
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发表时间：
2013-12-21
影响因子：
4.3
通讯作者：
Zignego, Anna Linda
中科院分区：
文献类型：
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作者：
Gragnani, Laura;Fognani, Elisa;Zignego, Anna Linda
混合性冷球蛋白血症是与丙型肝炎病毒感染关系最为密切的肝外表现，是一种良性的自身免疫性和淋巴增生性疾病，在5%-10%的病例中演变为淋巴瘤。MC被认为是一个多步骤、多因素的过程，其致病机制仍然知之甚少。目前尚不清楚为什么只有一些慢性感染的丙型肝炎患者发展为MC，并且这些患者中只有一些人表现出全身症状(MC综合征)。一些研究已经调查了MC的致病基础，最新的研究表明，只有在尚不清楚的遗传因素存在的情况下，病毒才能引发这种疾病。在这里，我们试图阐明丙型肝炎病毒相关的MC与宿主的遗传背景之间的复杂关系。我们报告的数据是不同的，有时甚至相互冲突。因此，显然需要进行大规模、多中心的研究。确定冷球蛋白血症患者的特征遗传特征将是临床护理中朝着个性化方法迈出的重要一步。新的广泛的基因组学技术有望帮助解决这些复杂的问题。(C)2013年白石登出版集团有限公司。版权所有。
Mixed cryoglobulinemia (MC) is the extrahepatic manifestation most strictly correlated with hepatitis C virus (HCV) infection; it is a benign autoimmune and lymphoproliferative disorder that evolves to lymphoma in 5%-10% of cases. MC is reputed to be a multistep and multifactorial process whose pathogenicity is still poorly understood. It is still unknown why only some chronically infected HCV patients develop MC and only some of these exhibit systemic symptoms (MC syndrome). Several studies have investigated the pathogenetic basis of MC and the most recent ones suggest that the virus is able to trigger such a disorder only in the presence of genetic factors that are still unknown. Here, we try to clarify the complex relationship between HCV-related MC and the host's genetic background. The data that we report are heterogeneous and sometimes even conflicting. Therefore, large, multicenter studies are clearly needed. The identification of a characteristic genetic signature of cryoglobulinemic patients would be an important step toward a personalized approach in their clinical care. The new wide-ranging genomics technologies will hopefully help to resolve these complex issues. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.