Modulation of B cell activation by extracellular vesicles and potential alteration of this pathway in patients with rheumatoid arthritis.

These data together suggest that m/lEVs have a direct modulatory effect in early responses of B cells through B cell receptor that can potentially fail in patients with RA because of the impact of these vesicles over cells of the innate immune system. This phenomenon can potentially contribute to the loss of tolerance and disease activity in patients with RA.