Cryoglobulinemic vasculitis: a 2023 update.
Journal
Current opinion in rheumatology
ISSN: 1531-6963
Titre abrégé: Curr Opin Rheumatol
Pays: United States
ID NLM: 9000851
Informations de publication
Date de publication:
01 Jan 2024
01 Jan 2024
Historique:
medline:
29
11
2023
pubmed:
2
11
2023
entrez:
2
11
2023
Statut:
ppublish
Résumé
Cryoglobulinemic vasculitis (CV) is an immune complex mediated small vessel vasculitis characterized by the presence of cryoglobulins in serum, often associated with hepatitis C infection, systemic autoimmune diseases or hematological conditions. The focus of this review is to provide an update on new insights into pathogenesis, epidemiology and therapies of infectious and noninfectious type II and type III CV. The introduction of new antiviral drugs for treatment of hepatitis C infection implied major changes in HCV-related CV, allowing to shed new lights on CV pathogenesis and mechanisms of relapse and, therefore, to increase the relevance of autoimmune diseases in CV epidemiology. Specific B-cell clones are involved in the production of pathogenic immune complexes that leads to small-vessel vasculitis. Therefore, both antiviral treatments [direct-acting antivirals (DAAs) and oral nucleot(s)ide analogues] and targeted anti-CD20 therapies (rituximab) prove to be safe and effective options, leading to a better prognosis. Association of Sjögren syndrome and CV defines a specific phenotype of patients, characterized by severe manifestations and poor outcome. Removing viral stimulation on B-cells through direct-acting antivirals and blocking B-cells proliferation and differentiation with rituximab are the goals of treatment of CV. However, further research is needed to identify prognostic factors of refractory and relapsing disease.
Identifiants
pubmed: 37916482
doi: 10.1097/BOR.0000000000000989
pii: 00002281-990000000-00092
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Antiviral Agents
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
27-34Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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