HLA-DRhigh/CD27high plasmablasts indicate active disease in patients with systemic lupus erythematosus.
OBJECTIVE
Monitoring of peripheral B-cell subsets in patients with systemic lupus erythematosus (SLE) revealed an activity-related expansion of CD27(++)CD20(-)CD19(dim) Ig-secreting cells. A similar subset has also been identified 6-8 days after tetanus/diphtheria vaccination in normal individuals and in patients with infectious disease.


METHODS
This subset was analysed further focussing on the HLA-DR surface expression in a cohort of 25 patients with SLE.


RESULTS
This study revealed that 86% (range 59-97%) of CD27(++)CD20(-)CD19(dim) cells express high levels of HLA-DR, are also expanded in the bone marrow, and represent plasmablasts enriched with anti-dsDNA secreting cells. The remaining CD27(++)CD20(-)CD19(dim) cells were HLA-DR(low) and represent mature plasma cells. Importantly, HLA-DR(high) plasmablasts showed a closer correlation with lupus activity and anti-dsDNA levels than the previously identified CD27(++)CD20(-)CD19(dim) cells.


CONCLUSIONS
HLA-DR(high)CD27(++)CD20(-)CD19(dim) plasmablasts represent a more precise indicator of lupus activity and suggest that there is an overproduction or lack of negative selection of these cells in SLE.
Jacobi
A M
AM
Charité Universitätsmedizin Berlin, Charitéplatz 1, 10098 Berlin, Germany.
Mei
H
H
Hoyer
B F
BF
Mumtaz
I M
IM
Thiele
K
K
Radbruch
A
A
Burmester
G-R
GR
Hiepe
F
F
Dörner
T
T
D000974:Antibodies, Antinuclear / Q000097:blood; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D001854:Bone Marrow Cells / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D010950:Plasma Cells / Q000276:immunology; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7 / Q000378:metabolism*
D000974:Antibodies, Antinuclear; D015415:Biomarkers; D006684:HLA-DR Antigens; D007074:Immunoglobulin G; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7