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AB0517 Dynamics of B Lymphocyte Subsets Counts in SLE Patients Treated with Rituximab
  1. A.A. Mesnyankina,
  2. E.N. Aleksandrova,
  3. S.K. Soloviev,
  4. A.P. Aleksankin,
  5. S.I. Gluhova,
  6. A.A. Novikov,
  7. E.A. Aseeva,
  8. E.V. Suponitskaya,
  9. E.L. Nasonov
  1. V.A. Nasonova Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

Objectives B subsets. To study the correlation between the counts of B cell subsets and SLE activity, and their dynamics after treatment with rituximab.

Methods Rituximab in doses from 500 to 2000 mg was administered to 8 SLE patients with high and moderate disease activity (1 male and 7 females), 6 patients had lupus nephritis. The relative counts of CD19 + B cells, the total population of memory B cells (CD19 + CD27 +), “preswitch” (CD19 + IgD + CD27 +) and “postswitch” (CD19 + IgD-CD27 +) memory B cells, naive (CD19 + IgD + CD27-) and transitional (CD19 + IgD + CD10 + CD38 ++ CD27-) B cells, plasmablasts (CD19 + CD38 +++ IgD-CD27 + CD20-), short-lived plasma cells (CD19 +, CD38 +), long-lived plasma cells (CD19 + CD138 +), and double negative B-cells (CD19 + CD27-IgD-) were measured. All B cell subsets were determined by multi-color flow cytometry using a panel of monoclonal antibodies to B-lymphocytes' surface membrane markers. Statistical analysis was performed using the U Mann-Whitney test.

Results There was no statistically significant correlation between SLE activity and B-cell subsets counts before initiation of rituximab, most likely due to a small sample size. 2-12 scores decrease by SLEDAI2K scale in SLE activity from average 19±5 score “before” to average 11±4 scores “after” was documented already in 3 months after initiation of rituximab. This was accompanied by reduction of CD 19+ levels (median 6.25% (4.2 -10,5); 0,1% (0,05-1,5), (p =0,004;)), count of short-lived plasma cells (CD19 +, CD38 +) (median 5.5% (2,2-7,15); 0,15% (0-1,3), (p =0,008)), memory B cells (CD19 + CD27 +) (median 1% (0,8-3); 0,05% (0-0,4), (p =0,01)), and naive (CD19 + IgD + CD27-) B cells (median 42.6% (22,9-49,75); 14% (2,15-21,2), (p =0,01)). Residual CD19 + cells during severe depletion phase were mostly represented by “preswitch” (CD19 + IgD + CD27 +) and “postswitch” (CD19 + IgD-CD27 +) memory B cells, and double negative memory B cells (CD19 + CD27-IgD -).

Conclusions Reduction of SLE clinical activity is associated with accompanying decrease in the counts of short-lived plasma cells (CD19 +, CD38 +), memory B cells (CD19 + CD27 +), naive (CD19 + IgD + CD27-) B-lymphocytes, which most likely indicates that these cells are major targets for anti-B cell therapy, as well as key players in autoimmune process development and progression.

Disclosure of Interest None declared

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