Increasing numbers of CD19 + CD24highCD38high regulatory B cells and pre-germinal center B cells reflect activated autoimmunity and predict future treatment response in patients with untreated immune thrombocytopenia.
Tetsuya HayashiHirohisa NakamaeShinichi TakedaYasuhiro NakashimaHideo KohMitsutaka NishimotoHiroshi OkamuraSatoru NannoYosuke MakuuchiMasatomo KunoMika NakamaeAsao HiroseMasayuki HinoPublished in: International journal of hematology (2021)
The pathophysiology of immune thrombocytopenia (ITP) is poorly understood, particularly aspects regarding abnormal homeostasis and dysregulation of B cells. In this study, we analyzed peripheral lymphocyte subsets in patients with untreated ITP and healthy controls, and examined correlations between cell percentages/counts and titers of serum cytokines and antibodies. We also compared ITP patients who later required second-line therapies and those who did not. The percentages of CD19 + CD24highCD38high regulatory B cells, pre-germinal center (GC) B cells, and plasmablast-like B cells were significantly higher in ITP patients than in healthy controls. Absolute counts of regulatory B cells and pre-GC B cells were significantly higher in those who needed second-line therapies. In addition, serum B cell-activating factor belonging to the tumor necrosis factor family (BAFF) levels and platelet-associated immune globulin G antibody titers correlated positively with regulatory B cell, pre-GC B cell, and auto-reactive B cell counts. Serum interferon-α (IFN-α) levels were elevated in four ITP patients with high auto-reactive B cell counts. These results indicate that increases in regulatory B cells and pre-GC B cells may reflect activated autoimmunity induced by BAFF and/or IFN-α. Consequently, evaluation of B cell subsets in untreated ITP patients may predict treatment response.
Keyphrases
- peripheral blood
- end stage renal disease
- ejection fraction
- chronic kidney disease
- dendritic cells
- prognostic factors
- peritoneal dialysis
- rheumatoid arthritis
- stem cells
- gas chromatography
- signaling pathway
- high resolution
- single cell
- mesenchymal stem cells
- patient reported outcomes
- celiac disease
- chemotherapy induced