title: HLA-DRhigh/CD27high plasmablasts indicate active disease in patients with systemic lupus erythematosus.
abstract: 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.
authors.affiliation: Charité Universitätsmedizin Berlin, Charitéplatz 1, 10098 Berlin, Germany.
authors.forename: A M
authors.initials: AM
authors.lastname: Jacobi
authors.forename: H
authors.initials: H
authors.lastname: Mei
authors.forename: B F
authors.initials: BF
authors.lastname: Hoyer
authors.forename: I M
authors.initials: IM
authors.lastname: Mumtaz
authors.forename: K
authors.initials: K
authors.lastname: Thiele
authors.forename: A
authors.initials: A
authors.lastname: Radbruch
authors.forename: G-R
authors.initials: GR
authors.lastname: Burmester
authors.forename: F
authors.initials: F
authors.lastname: Hiepe
authors.forename: T
authors.initials: T
authors.lastname: Dörner
mesh_terms: 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*
chemical_list: D000974:Antibodies, Antinuclear; D015415:Biomarkers; D006684:HLA-DR Antigens; D007074:Immunoglobulin G; D018127:Tumor Necrosis Factor Receptor Superfamily, Member 7