HLA-DRhigh/CD27high plasmablasts indicate active disease in patients with systemic lupus erythematosus
- A M Jacobi1,
- H Mei2,
- B F Hoyer1,
- I M Mumtaz1,
- K Thiele1,
- A Radbruch1,2,
- G-R Burmester1,
- F Hiepe1,2,
- T Dörner1,2
- 1Charité Universitätsmedizin Berlin, Berlin, Germany
- 2Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany
- Correspondence to Dr T Dörner, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10098 Berlin, Germany;
- Accepted 23 January 2009
- Published Online First 5 February 2009
Objectives: Monitoring of peripheral B-cell subsets in patients with systemic lupus erythematosus (SLE) revealed an activity-related expansion of CD27++CD20−CD19dim Ig-secreting cells. A similar subset has also been identified 6–8 days after tetanus/diphtheria vaccination in normal individuals and in patients with infectious disease.
Methods: This subset was analysed further focussing on the HLA-DR surface expression in a cohort of 25 patients with SLE.
Results: This study revealed that 86% (range 59–97%) of CD27++CD20−CD19dim cells express high levels of HLA-DR, are also expanded in the bone marrow, and represent plasmablasts enriched with anti-dsDNA secreting cells. The remaining CD27++CD20−CD19dim cells were HLA-DRlow and represent mature plasma cells. Importantly, HLA-DRhigh plasmablasts showed a closer correlation with lupus activity and anti-dsDNA levels than the previously identified CD27++CD20−CD19dim cells.
Conclusion: HLA-DRhighCD27++CD20−CD19dim plasmablasts represent a more precise indicator of lupus activity and suggest that there is an overproduction or lack of negative selection of these cells in SLE.
▸ Additional supplementary material and supplementary fig 1 is published online only at http://ard.bmj.com/content/vol69/issue1
Funding Supported by grant Do 491/5-5 and in part by SFB 650/TP16, the Deutsches Rheumaforschungszentrum is supported by the Senate of Berlin Germany.
Competing interests None.
Ethics approval The local Institutional Review Board (Charité Berlin) approved the study.
Patient consent Obtained.