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Hcv glomerulonephritis pathogenesis

Anu Gupta, Richard J Quigg
Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent worldwide. In this review, we discuss the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis (GN). The most common histopathologic presentation of HBV-GN is HBV-associated membranous nephropathy, which usually manifests clinically with varying grades of proteinuria and microscopic hematuria. The pathogenesis is likely to be immune complex mediated; however, other host and viral factors have been implicated...
September 2015: Advances in Chronic Kidney Disease
Paolo Conca, Giovanni Cafaro, Amalia De Renzo, Antonio Coppola, Ernesto Cimino, Giovanni Tarantino
Hepatitis C virus (HCV) has been recognized to be both a hepato- and lymphotropic virus. HCV lymphotropism represents an essential detail in the pathogenesis of virus-related autoimmune and lymphoproliferative disorders, ranging from clonal expansion of B-cells with organ and non-organ-specific autoantibody production up to overt non-Hodgkin's lymphoma along a continuous step-by-step model of B-cell lymphomagenesis, where the intermediated mixed cryoglobulinemia could be considered as a stage of suppressible antigen-driven lymphoproliferation...
2015: International Journal of Molecular Sciences
J Kowalewska, K Okoń, B Szynaka, B Naumnik
PURPOSE: Cryoglobulinemic glomerulonephritis (CGGN) is a type of membranoproliferative glomerulonephritis (MPGN) that develops in patients with systemic cryoglobulinemia. To date the exact pathogenesis of CGGN remains unclear. It has been suggested that macrophages may be significant contributors to the glomerular injury in this disease. In our study we attempt to characterize the macrophages in human CGGN using classical activation and regulatory macrophage markers. MATERIAL AND METHOD: We searched our database for renal biopsy cases of CGGN...
2013: Advances in Medical Sciences
Hao Wu, Hong-Bin Zou, Ying Xu, Li Zhang, Yu-Jun Du, Jin-Yu Yu, Rong-Hua Lu, Xiang Li
Heat-insoluble cryoglobulinemia is rare, and its pathogenesis and comorbidities remain poorly understood. Here, the authors report a case of hepatitis C virus (HCV)-related heat-insoluble cryoglobulinemia associated with thrombotic microangiopathy and cryoglobulin-occlusive membranoproliferative glomerulonephritis. The patient, a 57-year-old woman, presented with acute kidney injury, thrombocytopenia, anemia with schistocytes, high levels of serum HCV RNA of HCV genotype 2a, rheumatoid factor positivity and high levels of serum immunoglobulin (Ig) M and Igκ...
October 2013: American Journal of the Medical Sciences
Sydney C W Tang, Kar Neng Lai
Hepatitis C virus (HCV) infection remains a major global health burden. In addition to liver-related morbidity and mortality due to hepatic decompensation and development of hepatocellular carcinoma, extrahepatic manifestations of hepatitis C are frequent. Type I membranoproliferative glomerulonephritis associated with type II cryoglobulinemia is the most frequent association. The pathogenesis of the renal lesions is related to glomerular deposition of immune complexes. International guidelines recommend that patients with HCV-related glomerulopathies should be treated with antiviral therapy in the form of standard or pegylated interferon-α and ribavirin...
2013: Contributions to Nephrology
Yimin Lu, Pingyan Shen, Xiao Li, Yaowen Xu, Xiaoxia Pan, Weiming Wang, Xiaonong Chen, Wen Zhang, Hong Ren, Nan Chen
In recent years, significant advances have been made in understanding the pathogenesis and etiology of membranoproliferative glomerulonephritis (MPGN). A new classification system based on pathological immunofluorescence findings has been proposed to replace the traditional clinical classification system in order to better identify the underlying causes of MPGN and to provide guidance for more individualized treatment. We conducted a retrospective survey of the MPGN patients treated in our hospital from 2000 to 2012 and report here the validation of this new classification system in this cohort...
2013: Contributions to Nephrology
Giovanni Barbiano di Belgiojoso, Antonello Tosoni, Manuela Nebuloni
A wide spectrum of kidney diseases is observed in patients with HIV infection and renal involvement. After the introduction of highly active antiretroviral treatment (ART), the survival of patients has increased and the pattern of chronic kidney diseases changed. There has been a reduction in the prevalence of diseases more strictly related to HIV infection and an increase in comorbid conditions like diabetic nephropathy, nephroangiosclerosis, HCV hepatitis and drug-related tubulointerstitial nephritis, in particular related to antiretroviral drugs...
September 2012: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Diego Vergani, Giorgina Mieli-Vergani
Infections by the viruses responsible for hepatitis B, C and D are accompanied by a number of immunopathological manifestations. A link between infection and autoimmunity is particularly well documented for the hepatitis C virus. Immunopathological manifestations range from production of autoantibodies to overt autoimmune disease, including thyroiditis and autoimmune hepatitis, and to immune-complex-mediated disorders, including cryoglobulinaemia, glomerulonephritis and vasculitis. Several of these manifestations improve with successful antiviral treatment, directly incriminating the virus in their pathogenesis...
January 2013: Seminars in Immunopathology
Monika Merkle, Andrea Ribeiro, Franziska Belling, Hanna Mannell, Florian Krötz, Joachim Pircher, Markus Wörnle
Vascular endothelial growth factor (VEGF) plays an important role in glomerular homeostasis as well as in the pathogenesis of kidney diseases as glomerulonephritis (GN) and diabetic nephropathy. Mesangial cells (MC), which are an integral part of the functional glomerular filtration barrier in that providing structural support, can behave like inflammatory cells and produce mediators as chemokines and growth factors; they are known to express viral receptors, with TLR3 having been attributed relevance in viral disease-associated GN...
November 2012: Molecular and Cellular Biochemistry
Dimitrios Dimitroulis, Serena Valsami, Paraskevas Stamopoulos, Gregory Kouraklis
Infection with Hepatitis C virus (HCV) is affecting about 3% of the world's population, leading to liver damage, end-stage liver disease, and development of hepatocellular carcinoma, being thus the first indication for liver transplantation in the USA. Apart from the cirrhotic-liver-derived clinical signs and symptoms several conditions with immunological origin can also arise, such as, glomerulonephritis, pulmonary fibrosis, and thrombocytopenia. HCV-related autoimmune thrombocytopenia shows specific pathogenetic characteristics as well as symptoms and signs that differ in severity and frequency from symptoms in patients that are not HCV infected...
2012: Clinical & Developmental Immunology
Jose M Morales, N Kamar, L Rostaing
There is an increased evidence for the association between hepatitis C virus (HCV) infection and kidney diseases. Recent epidemiological studies strongly suggest that HCV infection is a risk factor for proteinuria and/or impaired renal function. Type I membranoproliferative glomerulonephritis (MPGN) associated with type II cryoglobulinemia is the most frequent renal disease, and non-cryoglobulinemic MPGN and membranous glomerulonephritis are less frequently associated with active HCV infection. The pathogenesis of these lesions are related to the deposition of immune complexes in the glomeruli, and recently it has been described that toll-like receptor 3 could have a pathogenic role establishing a link between viral infection and glomerulonephritis...
2012: Contributions to Nephrology
Jolanta Kowalewska
In humans cryoglobulinemic glomerulonephritis (CGGN) may develop in the course of systemic cryoglobulinemia (CG) and is often associated with hepatitis C virus infection. It is believed that the glomerular injury in CG results from the deposition of immune complexes, but exact sequence of events in this process is unknown. Experimental models of CGGN provide an important tool to study pathogenesis of this type injury. This review describes two mouse models of CGGN and their use in understanding the role of various molecules involved in regulation of inflammatory and fibrosis pathways, such as complement components, Fc receptors, growth factors, and others; as well as illustrates their role in testing novel approaches of treatment in this type of renal injury...
2011: Folia Histochemica et Cytobiologica
Stanislas Bataille, Gilles Kaplanski, José Boucraut, Philippe Halfon, Claire Camus, Laurent Daniel, Stéphane Burtey, Yvon Berland, Bertrand Dussol
BACKGROUND: We report on 3 cases of membranoproliferative glomerulonephritis associated with mixed cryoglobulin in patients with hepatitis C virus (HCV) antibodies but a negative blood viral load. These cases explore the pathogenesis of the renal disease. METHODS: We searched for occult HCV infection in peripheral blood mononuclear cells, cryoprecipitate, bone marrow cells, and glomeruli using ultrasensitive PCR assays and immunohistochemistry. We also looked for infraclinical B cell lymphoma by computed tomodensitometry, bone marrow aspiration and biopsy, and lymphocyte typing...
2012: American Journal of Nephrology
Chrisoula Pipili, George Ilonidis, Evangelos Cholongitas
The most frequent kidney disease associated with chronic hepatitis C virus (HCV) infection is membranoproliferative glomerulonephritis in patients with type II mixed cryoglobulinaemia. The principal clinical manifestations of glomerular disease in HCV-infected patients are the presence of proteinuria and haematuria with or without impaired kidney function. Pharmaceutical regimens vary because the main pathogenesis of renal dysfunction often mediated by cryoglobulins has not been fully elucidated. HCV infection remains common in patients on renal replacement therapy and has an adverse impact on their survival...
September 2011: Liver International: Official Journal of the International Association for the Study of the Liver
Maurizio Pietrogrande, Salvatore De Vita, Anna Linda Zignego, Pietro Pioltelli, Domenico Sansonno, Salvatore Sollima, Fabiola Atzeni, Francesco Saccardo, Luca Quartuccio, Savino Bruno, Raffaele Bruno, Mauro Campanini, Marco Candela, Laura Castelnovo, Armando Gabrielli, Giovan Battista Gaeta, Piero Marson, Maria Teresa Mascia, Cesare Mazzaro, Francesco Mazzotta, Pierluigi Meroni, Carlomaurizio Montecucco, Elena Ossi, Felice Piccinino, Daniele Prati, Massimo Puoti, Piersandro Riboldi, Agostino Riva, Dario Roccatello, Evangelista Sagnelli, Patrizia Scaini, Salvatore Scarpato, Renato Sinico, Gloria Taliani, Antonio Tavoni, Eleonora Bonacci, Piero Renoldi, Davide Filippini, Piercarlo Sarzi-Puttini, Clodoveo Ferri, Giuseppe Monti, Massimo Galli
OBJECTIVE: The objective of this review was to define a core set of recommendations for the treatment of HCV-associated mixed cryoglobulinemia syndrome (MCS) by combining current evidence from clinical trials and expert opinion. METHODS: Expert physicians involved in studying and treating patients with MCS formulated statements after discussing the published data. Their attitudes to treatment approaches (particularly those insufficiently supported by published data) were collected before the consensus conference by means of a questionnaire, and were considered when formulating the statements...
June 2011: Autoimmunity Reviews
Hideaki Yamabe, Norio Nakamura, Michiko Shimada, Reiichi Murakami, Takeshi Fujita, Yuko Shimaya, Maiko Kitajima, Mayumi Urushizaka
PURPOSE: Patients with hepatitis C virus (HCV)-associated glomerulonephritis in whom HCV RNA was not detected in the blood have been reported. We attempted to uncover the differences between HCV RNA-negative and HCV RNA-positive cases. METHODS: The clinical and pathological findings for 5 patients with HCV-associated glomerulonephritis without HCV in the blood were compared with those for 23 patients with HCV RNA-positive HCV-associated glomerulonephritis. RESULTS: The HCV RNA-negative cases were characterized by advanced age, female dominance, no cryoglobulinemia and no glomerular deposition of IgG compared with the HCV RNA-positive cases, although no differences were observed in amount of urinary protein, frequency of nephrotic syndrome, serum levels of total protein, creatinine level, presence of hypocomplementemia and rheumatoid factor...
2010: Internal Medicine
Fabrizio Fabrizi, Piergiorgio Messa, Carlo Basile, Paul Martin
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are the most common and serious causes of liver damage in patients with chronic kidney disease (CKD). The natural histories of HBV and HCV infections in patients with CKD are not fully understood; however, recent evidence has emphasized the adverse effect of HBV and/or HCV infection on survival in this population. Chronic liver disease is the fourth most important cause of death after renal transplantation. The negative effect of HCV infection on survival among renal transplant recipients has been linked to liver dysfunction and extrahepatic complications, such as chronic glomerulonephritis, post-transplantation diabetes mellitus, chronic allograft nephropathy, and sepsis...
July 2010: Nature Reviews. Nephrology
Yali Cao, Youkang Zhang, Suxia Wang, Wanzhong Zou
BACKGROUND: Several studies have postulated a causal link between hepatitis C virus (HCV) infection and renal diseases through the induction of cryoglobulinaemia. However, the detection of viral antigens within kidneys of HCV-infected patients has proved to be difficult. We studied a cohort of Chinese HCV-infected patients with various glomerulonephritis (GN) in an attempt to detect HCV antigens within their kidneys. METHODS: Twenty-one patients with various GN were found to be serum HCV-antibody positive (seven serum HCV-RNA positive simultaneously), at the time of renal biopsy, from January 2005 to April 2008 in our hospital...
September 2009: Nephrology, Dialysis, Transplantation
Susan Ray, Kelly Rouse, Andrew Appis, Robert Novak, Nairmeen Awad Haller
Fibrillary glomerulonephritis (FGN) is a relatively rare cause of renal disease, found in only 0.6-1.5% of native renal biopsies. The pathogenesis of FGN is not well described, and very few associations with disease processes other than hepatitis C virus (HCV) have been made. We describe a case that provides evidence in support of the FGN-HCV association, as well as introduces the association of FGN-HCV and hypocomplementemia. The case is a 53-year-old African-American female demonstrating a classical presentation of FGN complicated by a concomitant HCV infection...
2008: Renal Failure
Paul Martin, Fabrizio Fabrizi
Hepatitis C virus (HCV) infection remains frequent in patients on renal replacement therapy and has an adverse impact on survival in infected patients on chronic hemodialysis as well as renal transplant (RT) recipients. Nosocomial spread of HCV within dialysis units continues to occur. HCV is also implicated in the pathogenesis of renal dysfunction often mediated by cryoglobulins leading to chronic kidney disease as well as impairing renal allograft function. The role of antiviral therapy for hepatitis C in patients with renal failure remains unclear...
October 2008: Journal of Hepatology
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