Systemic sclerosis & Raynaud's
Myeloablative autologous haematopoietic stem cell transplantation resets the B cell repertoire to a more naïve state in patients with systemic sclerosis
Authors' conclusion
Together, these findings suggest that myeloablative autologous HSCT resets the IGH repertoire to a more naïve state characterised by IgM-expressing B cells, providing a possible mechanism for the elimination of pathogenic B cells that may contribute to the benefit of HSCT over CYC in the treatment of dcSSc.
Study context
- Population
- Patients with diffuse cutaneous systemic sclerosis (dcSSc) enrolled in the SCOT trial
- Comparison
- Myeloablative autologous haematopoietic stem cell transplant (HSCT) vs CYC
- Outcome
- Peripheral blood IGH repertoire
Methodological detailsIGH repertoire sequencing within the SCOT trial
- IGH repertoire sequencing within the SCOT trial
Main finding
As reported in the abstract
- HSCT associated with a sustained increase in IgM isotype antibodies bearing a low mutation rate
- Clonal expression reduced in IGH repertoires after HSCT
- Underusage of IGH V gene 5-51 in dcSSc; usage normalised after HSCT but not CYC
Original publication
Myeloablative autologous haematopoietic stem cell transplantation resets the B cell repertoire to a more naïve state in patients with systemic sclerosis. Ann Rheum Dis. Published 14 October 2022. doi:10.
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