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Blood, 15 November 2000, Vol. 96, No. 10, pp. 3578-3584
NEOPLASIA
Sequence analysis of the immunoglobulin antigen receptor of
hepatitis C virus-associated non-Hodgkin lymphomas suggests that the
malignant cells are derived from the rheumatoid factor-producing
cells that occur mainly in type II cryoglobulinemia
Valli De Re,
Salvatore De Vita,
Alessandra Marzotto,
Maurizio Rupolo,
Annunziata Gloghini,
Barbara Pivetta,
Daniela Gasparotto,
Antonino Carbone, and
Mauro Boiocchi
From the Divisions of Experimental Oncology 1, Medical
Oncology, and Pathology, Centro di Riferimento Oncologico, Aviano,
Italy; Chair and Division of Rheumatology, DPMSC, University of Udine,
Udine, Italy.
Analysis of the immunoglobulin receptor (IGR) variable heavy-
and light-chain sequences on 17 hepatitis C virus (HCV)-associated non-Hodgkin lymphomas (NHLs) (9 patients also had type II mixed cryoglobulinemia [MC] syndrome and 8 had NHL unrelated to MC) and
analysis of intraclonal diversity on 8 of them suggest that such
malignant lymphoproliferations derive from an antigen-driven pathologic
process, with a selective pressure for the maintenance of a functional
IgR and a negative pressure for additional amino acid mutations in the
framework regions (FRs). For almost all NHLs, both heavy- and
light-chain complementarity-determining regions (CDR3) showed the
highest similarity to antibodies with rheumatoid factor (RF) activity
that have been found in the MC syndrome, thus suggesting that a common
antigenic stimulus is involved in MC syndrome and in HCV-associated
lymphomagenesis. Moreover, because HCV is the recognized pathologic
agent of MC and the CDR3 amino acid sequences of some HCV-associated
NHLs also present a high homology for antibody specific for the E2 protein of HCV, it may be reasonable to speculate that HCV E2 protein
is one of the chronic antigenic stimuli involved in the lymphomagenetic process. Finally, the use of specific
segments, in particular the D segment, in assembling the IgH chain of
IgR seems to confer B-cell disorders with the property to produce antibody with RF activity, which may contribute to the manifestation of
an overt MC syndrome.

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