Vasculitis & polymyalgia rheumatica
Autoreactive Plasmablasts After B Cell Depletion With Rituximab and Relapses in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
Authors' conclusion
The composition of the autoreactive B cell pool varies significantly following RTX treatment in AAV, and early plasmablast enrichment within the autoreactive pool is associated with future relapses.
Study context
- Population
- Patients with PR3-ANCA-positive ANCA-associated vasculitis (AAV) treated with rituximab (RTX) for remission induction and monitored after stopping therapy during long-term follow-up in a prospective clinical trial148 PBMC samples
- Participants
- 23 patients
- Comparison
- Circulating PR3-specific B cell pool at B cell recurrence after RTX vs baseline; patients with relapse vs those in remission
- Outcome
- Autoreactive (PR3+) B cell pool at B cell recurrence (first sample with ≥10 B cells/μl after RTX)
- Follow-up
- B cell recurrence
Methodological detailsprospective, sequential flow cytometry
- Prospective
- Sequential flow cytometry
Main finding
As reported in the abstract
- PR3+ B cell frequency among B cells higher than baseline
- P < 0.01
- Within PR3+ and total B cells, transitional and naive subsets higher and memory subsets lower than baseline
- P < 0.001 for all comparisons
- PR3+ plasmablast frequencies higher than baseline more likely in patients relapsing within the following 12 months vs sustained remission
- P < 0.05
Original publication
Autoreactive Plasmablasts After B Cell Depletion With Rituximab and Relapses in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis. Arthritis Rheumatol. Published 15 March 2023. doi:10.
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