Correlation between circulating CD27^high plasma cells and disease activity in patients with systemic lupus erythematosus

Abstract

Objective. Disease activity in systemic lupus erythematosus (SLE) is usually assessed with complex disease activity scores comprising a variety of different parameters. In order to determine whether SLE disease activity correlates with abnormal B lymphocyte activity, B cell subsets were analyzed, and their relationship to clinical and humoral measures of disease activity was assessed.Methods. The distribution of B cell subsets was determined by fluorescence-activated cell sorting analysis and assessed in relation to the autoantibody profile, disease activity measured by the SLE Disease Activity Index (SLEDAI) and the European Consensus Lupus Activity Measure scores, disease duration, and therapy.Results. The number and frequency of CD27 high plasma cells were significantly correlated with the SLE disease activity indices and with the titer of antidouble-stranded DNA (anti-dsDNA) autoantibodies. Circulating B cell subsets were not influenced by age or sex, but appeared to relate to the duration of disease and the therapeutic regimen, with the number and frequency of CD27 high plasma cells increasing and those of CD27؊ naive B cells decreasing over time. Patients were divided into those with a SLEDAI score of 0-8 (low disease activity) and those with SLEDAI score >8 (high disease activity). Patients with high disease activity had an increased frequency of both CD19؉ B cells and CD27 high plasma cells. By using a nonparametric data sieving algorithm, we observed that these B cell abnormalities provided predictive values for nonactive and active disease of 78.0% and 78.9%, respectively. The predictive value of the B cell abnormalities (78.9%) was greater than that of the humoral/clinical data pattern (71.4%), including anti-dsDNA antibody levels, circulating immune complexes, increased erythrocyte sedimentation rate, mucocutaneous involvement, and acute renal involvement.Conclusion. Flow cytometric monitoring of B cell subsets in the peripheral blood provides new insights into abnormalities of B cell function in SLE and may also be a diagnostically valuable option for monitoring the activity of this autoimmune disease.

CD40-activated B cells from patients with systemic lupus erythematosus can be modulated by therapeutic immunoglobulins in vitro

“…In addition, the frequency of CD27 + cells was higher in SLE B cells following long-term stimulation. These observations are in agreement with previous studies on SLE reporting higher frequencies of CD27 + blood B cells and plasma cells (Arce et al 2001;Jacobi et al 2003;Odendahl et al 2000), which could be prone to rapid differentiation into Ig-secreting cells through Fig. 3.…”

“…Lymphopenia is commonly observed in SLE manifested by decreased numbers of T cells, including CD4 + and CD8 + cells (Wouters et al 2004), as well as B cells (Odendahl et al 2000). Homeostasis within peripheral B cells from SLE patients is disturbed and can be characterized by an increased frequency of CD27 + cells (Odendahl et al 2000;Jacobi et al 2003). SLE patients with active disease have a higher frequency of circulating blood plasma cells (Harada et al 1996;Jacobi et al 2003).…”

“…Homeostasis within peripheral B cells from SLE patients is disturbed and can be characterized by an increased frequency of CD27 + cells (Odendahl et al 2000;Jacobi et al 2003). SLE patients with active disease have a higher frequency of circulating blood plasma cells (Harada et al 1996;Jacobi et al 2003). Aberrant levels of soluble or surface molecules involved in B-cell activation, such as interleukin (IL)-10, BAFF, CD40, and CD154 (Gonzalez-Amaro et al 1998;Sun et al 2000;Zouali 2005), as well as enhanced calcium release, defective FcγRIIB signaling, and reduced expression of Lyn [reviewed in (Pugh-Bernard and Cambier 2006)] can all be observed in SLE.…”

Systemic lupus erythematosus and infections: Clinical importance of conventional and upcoming biomarkers

“…Among quantitative cellular measurements, such candidates would be Fc receptors [35], and the percentage of circulating CD27 high plasma cells in the peripheral blood [36,37]. They have the advantage of timely and early evaluation of the patient (within four to six hours after the contact with microbial surface agents) but flow-cytometry is a resource consuming technique and these tests could not be available as a routinely tested approach in all laboratories.…”

“…Among cell markers, previous studies have also focused on the frequency of CD27 high plasma cells [36,37]. It has been described that CD27 high plasma cell frequency is high in SLE patients and that it correlates with SLE disease activity index (SLEDAI) and some ENA antibodies [36,37].…”