[The cryoglobulinemic syndrome--report from the workshop on classification and on the 10th conference of the Italian Society for the treatment of Cryoglobulinemia, Modena, 29 Sept., 2003].

The conference was preceded by a workshop of an European expert group on the n evaluation, testing, and workup of a new classification for cryoglobulinemic syndrome. Several studies on the potential role of infections, especially hepatitis C virus (HCV) and cytomegalovirus (CMV), in the pathogenesis of human autoimmune diseases were presented and discussed at the conference. A cross-reactivity between CMV proteins and different auto-antigens could play a role with respect to the initial endothelial damage in the pathogenesis of systemic sclerosis. A number of immune mechanisms may be involved in the induction of the cryoglobulinemic syndrome such as the formation of cross-reacting antibodies, chronic B-cell stimulation, an interaction between the HCV core protein and tumor suppressor genes p53 and/or proto-oncogens, and the t(14;18) translocation with bcl-2 activation and prolonged B-cell survival.