Immunopatho Genesis of HCV-Related CryoglobulinemiaGlobal B-cell stimulation may be fundamental to HCV-related cryoglobulinemia, which is a consequence of chronic antigenic stimulation of the humeral immune system. It is believed that the hepatitis C virus attaches itself to B lymphocyte cells, which causes the immune system to produce auto-antibodies [6].It is suggested that a proto-oncogene named Bcl-2, when activated, increases B-cell survival by inhibiting apoptosis. This could lead to increased B-cell quantities which may lead to the increased production of auto antibodies and cryoglobulins [7]. Another possibility suggested is that the HCV E2 envelope protein binds to the cell surface glycoprotein CD81 that is present on B cells as well as on hepatocytes, thus reducing the threshold for B-cell activation. A molecular mimicry with NS5A and NS core proteins of HCV can be hypothesized, which might simulate host auto antigens resulting in B-lymphocyte activation and autoantibody production [6,7].
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