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https://hdl.handle.net/2440/92706
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Type: | Journal article |
Title: | Changes in peripheral blood B cell subsets at diagnosis and after treatment with disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis: correlation with clinical and laboratory parameters |
Author: | McComish, J. Mundy, J. Sullivan, T. Proudman, S. Hissaria, P. |
Citation: | International Journal of Rheumatic Diseases, 2015; 18(4):421-432 |
Publisher: | Wiley |
Issue Date: | 2015 |
ISSN: | 1756-1841 1756-185X |
Statement of Responsibility: | Jeremy McComish, Joy Mundy, Tom Sullivan, Susanna M. Proudman and Pravin Hissaria |
Abstract: | OBJECTIVE: To assess variation in peripheral blood B lymphocyte subsets in rheumatoid arthritis (RA). METHODS: B lymphocyte subsets in disease-modifying anti-rheumatic drug (DMARD)-naïve patients with RA (n = 30), patients with RA treated with DMARDs (n = 73) and healthy controls (n = 46) were analyzed by flow cytometry. Total B cells, total memory B cells, immunoglobulin M (IgM) memory B cells, switched memory B cells, non-switched memory B cells, CD21lo B cells, transitional B cells and plasmablasts were measured. Correlation with clinical and laboratory parameters was performed. RESULTS: Total memory B cells, IgM memory B cells and non-switched memory B cells were reduced in RA patients at diagnosis compared to controls (P < 0.05). In patients with treated RA, there was a further reduction of total B cells, CD21lo cells, transitional B cells and plasmablasts, compared to controls (P < 0.05). The reduction in absolute numbers of total B cells, switched memory B cells, CD21lo cells, transitional B cells and plasmablasts in treated RA patients was significant (P < 0.05) even when compared to the DMARD-naïve patients. Only treatment responders (Disease Activity Score < 3.2) had reduced total B cells and absolute numbers of switched and IgM memory B cells (P < 0.05). In patients requiring leflunomide, total memory B cells, IgM memory B cells, non-switched memory B cells and absolute numbers of switched memory B cells were reduced compared with the remainder of the patient group (P < 0.05). CONCLUSION: There is reduction of various B cell subsets in RA patients at diagnosis. Treatment with DMARDs leads to further reduction in additional B cell subsets without correction of the abnormalities. Reduction in individual subsets may predict RA patients requiring more intensive therapy. |
Keywords: | B cell subsets B cells CCP/ACPA disease-modifying anti-rheumatic drugs flow cytometry memory B cells rheumatoid arthritis |
Rights: | © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd |
DOI: | 10.1111/1756-185X.12325 |
Published version: | http://dx.doi.org/10.1111/1756-185x.12325 |
Appears in Collections: | Aurora harvest 2 Public Health publications |
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