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FRI0235 Alterations in peripheral B cell subsets of patients with anca associated vasculitides (AAVS) after immunosuppressive therapy
  1. N. Venhoff1,
  2. N. Effelsberg1,
  3. F. Haessler1,
  4. R. Draeger1,
  5. D. Lebrecht1,
  6. R.E. Voll1,2,
  7. U. Salzer2,
  8. M. Schlesier1,
  9. J. Thiel1
  1. 1Rheumatology and Clinical Immunology
  2. 2Centre of Chronic Immunodeficiency, University Hospital Freiburg, Freiburg, Germany

Abstract

Background B lymphocytes are involved in the pathogenesis of AAVs by the production of cytokines/chemokines and autoantibodies. Immunosuppressive therapy is effective in AAVs but may lead to a decline in serum immunoglobulin (Ig) concentrations and to changes in the peripheral B cell compartment.

Objectives To assess the effect of immunosuppressive treatment on the peripheral B cell compartment in AAV patients.

Methods In 36 AAV patients a retrospective analysis of Ig concentrations and flowcytometry of peripheral B-cells was conducted. A group of 26 healthy donors served as control.

Results 33 of 36 AAV patients were treated with cyclophosphamide (CYC) prior to analysis (median cumulative dose 14.5g; IQR 5.825-30). At the time of analysis 29 patients were treated with prednisone (median dose 5mg/d; IQR 3.75-8.75), eight received methotrexate (MTX), six azathioprine (AZA), six leflunomide (LEF), four mycophenolate mofetile, and eleven patients had no DMARD. Decreased IgG serum concentrations (<7g/L) were detected in 14 patients. Compared to healthy controls absolute cell counts and relative percentages of lymphocytes and CD19+ B cells were significantly decreased in AAV patients (Table 1). Notably, IgD+CD27+ marginal zone B cells were significantly decreased in AAV patients both in absolute cell counts and relative percentages. IgD+CD27- naive B cells, IgD-CD27+ memory B cells, IgA+ B cells, transitional B cells and plasmablasts were significantly decreased in absolute numbers but not in relative percentages. In the subgroup of AZA treated patients absolute numbers of all B cell subpopulations except for IgA+ B cells and plasmablasts were reduced. In LEF treated patients only IgD+CD27+ B cells were reduced. In MTX-treated patients only IgD+CD27+ B cells were reduced both in absolute numbers and percentage while IgD+CD27- and IgD-CD27+ B cells, IgA+ B cells and plasmablasts were decreased only in absolute numbers.

Conclusions Immunosuppressive therapy leads to a decrease in absolute numbers of CD19+ B cells and all examined B cell subpopulations, while IgD+ CD27+ MZ-like B cells showed also a relative decrease.

Disclosure of Interest None Declared

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