Abstract
The unexplained association between infection and autoimmune disease is strongest for hepatitis C virus-induced cryoglobulinemic vasculitis (HCV-cryovas). To analyze its origins, we traced the evolution of pathogenic rheumatoid factor (RF) autoantibodies in four HCV-cryovas patients by deep single-cell multi-omic analysis, revealing three sources of B cell somatic mutation converged to drive the accumulation of a large disease-causing clone. A method for quantifying low-affinity binding revealed recurring antibody variable domain combinations created by V(D)J recombination that bound self-immunoglobulin G (IgG) but not viral E2 antigen. Whole-genome sequencing revealed thousands of somatic mutations, numerically comparable to chronic lymphocytic leukemia and normal memory B cells, but with 1–2 corresponding to driver mutations found recurrently in B cell leukemia and lymphoma. V(D)J hypermutation created autoantibodies with compromised solubility in complex with self-IgG. In this virus-induced autoimmune disease, infection promotes a catastrophic confluence of somatic mutagenesis in the descendants of a single B cell.
| Original language | English |
|---|---|
| Pages (from-to) | 412-430.e10 |
| Number of pages | 29 |
| Journal | Immunity |
| Volume | 58 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 11 Feb 2025 |
Keywords
- antibody affinity
- antigenic mimicry
- autoantibody
- B lymphocyte
- cryoglobulinemic vasculitis
- hepatitis C virus
- rheumatoid factor
- somatic mutation
- superselectivity