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HLA-DRhigh/CD27high plasmablasts indicate active disease in patients with SLE
  1. Annett M Jacobi (annett.jacobi{at}
  1. Charité University Hospital, Germany
    1. Henrik Mei (mei{at}
    1. DRFZ Berlin, Germany
      1. Bimba F Hoyer (bimba.hoyer{at}
      1. Charite Berlin, Germany
        1. Imtiaz M Mumtaz
        1. Charite Berlin, Germany
          1. Kathi Thiele
          1. Charite Berlin, Germany
            1. Andreas H Radbruch (radbruch{at}
            1. Charité - Universitätsmedizin Berlin, Germany
              1. Gerd R Burmester (gerd.burmester{at}
              1. Charite University Hospital, Germany
                1. Falk Hiepe (falk.hiepe{at}
                1. Charité - Universitätsmedizin Berlin, Germany
                  1. Thomas Dörner (thomas.doerner{at}
                  1. Charite Univ. Hospital, Germany


                    Objectives: Monitoring of peripheral B cell subsets in patients with 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: We analyzed this subset 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 (BM), 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.

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