Regulatory B cell expansion and type 1 innate lymphoid cell suppression characterise immune modulation in paediatric lupus nephritis
Authors' conclusion
BAFF inhibition in paediatric LN is associated with rebalancing of innate and adaptive immunity through enhancement of Breg function and suppression of ILC1-driven inflammation.
Study context
- Population
- Paediatric patients with biopsy-confirmed class III/IV lupus nephritis (LN)60 randomised LN patients plus controls
- Participants
- 30 / 30 / 10 / 3
- Comparison
- Standard therapy plus belimumab vs standard therapy
- Belimumabn = 30
- Standard therapyn = 30reference
- Healthy childrenn = 10
- Minimal change diseasen = 3
Methodological detailsprospective, open-label
- Prospective
- Open-label
Primary result
As reported in the abstract
- Belimumab associated with greater increases in serum C3, reductions in anti-dsDNA titres, decreased proteinuria, improved SLEDAI-2K scores and reduced corticosteroid exposure
- Belimumab expanded memory B cells and IL-10-producing CD19+CD5+ and CD19+CD24hi+CD38hi+ Bregs, with enhanced suppression of CD4+ T cell proliferation
- Reduced circulating and renal innate lymphoid cells (ILC1s), downregulated interferon (IFN)-stimulated genes and modulated inflammatory pathways
- Decreased serum IFN-γ, IL-17A, IL-10 and BAFF, increased IL-35
- Phosphorylation of aryl hydrocarbon receptor and STAT3 in Bregs partially restored
Original publication
Regulatory B cell expansion and type 1 innate lymphoid cell suppression characterise immune modulation in paediatric lupus nephritis. RMD Open. Published 13 May 2026. doi:10.
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