TY - JOUR T1 - B cell subset composition segments clinically and serologically distinct groups in chronic cutaneous lupus erythematosus JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis DO - 10.1136/annrheumdis-2021-220349 SP - annrheumdis-2021-220349 AU - Scott A Jenks AU - Chungwen Wei AU - Regina Bugrovsky AU - Aisha Hill AU - Xiaoqian Wang AU - Francesca M Rossi AU - Kevin Cashman AU - Matthew C Woodruff AU - Laura D Aspey AU - S. Sam Lim AU - Gaobin Bao AU - Cristina Drenkard AU - Ignacio Sanz Y1 - 2021/06/03 UR - http://ard.bmj.com/content/early/2021/06/03/annrheumdis-2021-220349.abstract N2 - Objective While the contribution of B-cells to SLE is well established, its role in chronic cutaneous lupus erythematosus (CCLE) remains unclear. Here, we compare B-cell and serum auto-antibody profiles between patients with systemic lupus erythematosus (SLE), CCLE, and overlap conditions.Methods B-cells were compared by flow cytometry amongst healthy controls, CCLE without systemic lupus (CCLE+/SLE−) and SLE patients with (SLE+/CCLE+) or without CCLE (SLE+/CCLE−). Serum was analyed for autoreactive 9G4+, anti-double-stranded DNA, anti-chromatin and anti-RNA antibodies by ELISA and for anti-RNA binding proteins (RBP) by luciferase immunoprecipitation.Results Patients with CCLE+/SLE− share B-cell abnormalities with SLE including decreased unswitched memory and increased effector B-cells albeit at a lower level than SLE patients. Similarly, both SLE and CCLE+/SLE- patients have elevated 9G4+ IgG autoantibodies despite lower levels of anti-nucleic acid and anti-RBP antibodies in CCLE+/SLE−. CCLE+/SLE− patients could be stratified into those with SLE-like B-cell profiles and a separate group with normal B-cell profiles. The former group was more serologically active and more likely to have disseminated skin lesions.Conclusion CCLE displays perturbations in B-cell homeostasis and partial B-cell tolerance breakdown. Our study demonstrates that this entity is immunologically heterogeneous and includes a disease segment whose B-cell compartment resembles SLE and is clinically associated with enhanced serological activity and more extensive skin disease. This picture suggests that SLE-like B-cell changes in primary CCLE may help identify patients at risk for subsequent development of SLE. B-cell profiling in CCLE might also indentify candidates who would benefit from B-cell targeted therapies.Data are available upon reasonable request. All data including deidentified patient data,flow cytometry files and R code are available upon reasonable request from Dr Ignacio Sanz, ignacio.sanz@emory.edu. ER -