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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(s) -
McComish Jeremy,
Mundy Joy,
Sullivan Tom,
Proudman Susanna M.,
Hissaria Pravin
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12325
Subject(s) - medicine , memory b cell , rheumatoid arthritis , b cell , immunology , flow cytometry , naive b cell , antibody , lymphocyte , t cell , immune system , antigen presenting cell
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 ( I g M ) 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 DMARD s 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.