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HLA-DRhigh/CD27high plasmablasts indicate active disease in patients with systemic lupus erythematosus
  1. A M Jacobi1,
  2. H Mei2,
  3. B F Hoyer1,
  4. I M Mumtaz1,
  5. K Thiele1,
  6. A Radbruch1,2,
  7. G-R Burmester1,
  8. F Hiepe1,2,
  9. T Dörner1,2
  1. 1
    Charité Universitätsmedizin Berlin, Berlin, Germany
  2. 2
    Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany
  1. Correspondence to Dr T Dörner, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10098 Berlin, Germany; thomas.doerner{at}charite.de

Abstract

Objectives: Monitoring of peripheral B-cell subsets in patients with systemic lupus erythematosus (SLE) revealed an activity-related expansion of CD27++CD20CD19dim 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++CD20CD19dim 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++CD20CD19dim 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++CD20CD19dim cells.

Conclusion: HLA-DRhighCD27++CD20CD19dim 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.

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Footnotes

  • ▸ 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.

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