Chemokine (CXC motif) ligand 9 serum levels in mixed cryoglobulinaemia are associated with circulating levels of IFN-gamma and TNF-alpha

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Rheumatology ArticleA. Antonelli, P. Fallahi, S. Ferrari, A. Corrado, M. Sebastiani, A. Manfredi, S. Frascerra, M. Miccoli, A. Zigniego, E. Ferrannini, C. Ferri

Department of Internal Medicine University of Pisa School of Medicine, Pisa, Italy. alessandro.antonelli@med.unipi.it

CER5070 Submission on line 2012 Vol.30, N°6 - PI 0864, PF 0870
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No study evaluated circulating chemokine (CXC motif) ligand (CXCL)9 in `patients with mixed cryoglobulinaemia and hepatitis C virus chronic infection` (MC+HCV). We aimed to measure CXCL9, IFN-γ and TNF-α in a series of MC+HCV to correlate these parameters to different clinical phenotypes.
Serum CXCL9, IFN-γ and TNF-α were assayed in 54 MC+HCV, in 54 patients with HCV chronic infection (HCV+) and in 54 sex- and age-matched controls.
MC+HCV showed significantly higher mean CXCL9 than HCV+ patients (p=0.01; ANOVA) or controls (p=0.0001; ANOVA), in particular in 21 cryoglobulinaemic patients with active vasculitis compared to those without (p<0.001; ANOVA). Serum IFN-γ (in patients with detectable IFN-γ) and TNF-α were significantly higher in MC+HCV than in controls (p<0.05, Mann-Whitney U test; p<0.0001, Mann-Whitney U-test; respectively). CXCL9, evaluated by classes of IFN-γ (IFN-γ<2; 2<IFN-γ<5; IFN-γ>5 pg/mL), or TNF-α (TNF-α<2; 2<TNF-α<10; TNF-α>10 pg/mL), showed a progressive, but not significant, increase of circulating values. When the combination of high circulating levels of IFN-γ and TNF-α (IFN-γ>2 and TNF-α>10 pg/mL vs. IFN-γ<2 and/or TNF-α<10 pg/mL) was evaluated, significantly higher CXCL9 levels were observed (p<0.01; ANOVA).
We demonstrated markedly high serum levels of CXCL9 in MC+HCV (vs. HCV+ patients or healthy controls), significantly associated with the presence of active vasculitis. A strong relation among high levels of circulating IFN-γ, TNF-α and serum CXCL9 has been shown in MC+HCV. Larger patients` series will be needed to evaluate the relevance of serum CXCL9 determination as clinico-prognostic marker of MC+HCV.

PMID: 22766105 [PubMed]

Received: 06/09/2011 - Accepted : 24/01/2012 - In Press: 17/12/2012 - Published: 17/12/2012