mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2026-1-29-35mrj-1902Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSАнализ изменений субпопуляций В-лимфоцитов периферической крови у пациентов с болезнью ШегренаAnalysis of changes in peripheral blood B lymphocyte subpopulations in patients with Sjögren’s diseasehttps://orcid.org/0000-0001-8099-2107ТоргашинаА. В.TorgashinaA. V.

Анна Васильевна Торгашина

Россия, 115522, Москва, Каширское шоссе, 34А

 34A, Kashirskoe Shosse, Moscow 115522, Russia 

anna.torgashina@gmail.comhttps://orcid.org/0009-0003-7621-5833ВеретенниковА. С.VeretennikovA. S.

Россия, 119991, Москва, Ленинские горы, 1

 21, Leninskie Gory, Moscow 119991, Russia 

https://orcid.org/0000-0003-4188-3578ЧальцевБ. Д.ChaltsevB. D.

 Россия, 115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0003-2314-1466ХванЮ. И.KhvanYu. I.

 Россия, 115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0003-3057-9175АвдееваА. С.AvdeevaA. S.

 Россия, 115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0001-6686-0896АлексанкинА. П.AleksankinA. P.

 Россия, 115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522, Russia

https://orcid.org/0000-0003-3183-0464ДибровД. А.DibrovD. A.

 Россия, 115522, Москва, Каширское шоссе, 34А 

34A, Kashirskoe Shosse, Moscow 115522, Russia

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»РоссияLomonosov Moscow State UniversityRussian Federation2026190220262012935Copyright © Торгашина А.В., Веретенников А.С., Чальцев Б.Д., Хван Ю.И., Авдеева А.С., Алексанкин А.П., Дибров Д.А., 20262026Торгашина А.В., Веретенников А.С., Чальцев Б.Д., Хван Ю.И., Авдеева А.С., Алексанкин А.П., Дибров Д.А.Torgashina A.V., Veretennikov A.S., Chaltsev B.D., Khvan Y.I., Avdeeva A.S., Aleksankin A.P., Dibrov D.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1902

Нарушение распределения периферических В-клеток служит маркером В-клеточной гиперактивации при болезни Шегрена (БШ).Цель исследования – установить взаимосвязь между уровнем различных субпопуляций B-лимфоцитов периферической крови и клинико-лабораторными проявлениями БШ.Материал и методы. В исследование включено 103 пациента с БШ (основная группа) и 31 здоровый донор (контрольная группа). Диагноз БШ был установлен на основании критериев ACR/EULAR 2016 г., все пациенты прошли полное клинико-лабораторное обследование. Анализ субпопуляций B-лимфоцитов проводился методом проточной цитометрии. Анализировались CD19+ В-клетки, CD19+CD27+ B-клетки памяти, В-клетки памяти с непереключенным фенотипом иммуноглобулинов («непереключенные», CD19+IgD+CD27+), В-клетки памяти с переключенным фенотипом иммуноглобулинов («переключенные», CD19+IgD-CD27+), наивные B-клетки памяти (CD19+IgD+CD27-), дважды негативные B-клетки памяти (CD19+IgD-CD27-), транзиторные В-клетки памяти (CD19+IgD+CD10+CD38+), плазмобласты (CD19+СD38+++IgD-CD27+), плазмоциты (CD19+СD38+). Статистический анализ проводился с помощью программы GraphPad Prism 8.Результаты и обсуждение. У пациентов с БШ по сравнению со здоровыми донорами наблюдалось снижение числа CD19+ В-клеток (p=0,0089), CD27+ клеток памяти (p=0,018) и увеличение количества плазмобластов (p<0,0001). Корреляционный анализ показал связь уровня IgG с повышенным содержанием плазмобластов (r=0,76, p=0,0038) и плазмоцитов (r=0,81, p=0,0001), а также обратную корреляцию с числом В-клеток памяти (r=-0,72, p=0,006). У пациентов с повышением концентрации IgG (>16 мг/л) отмечалось большее количество наивных В-клеток (p=0,0047) и меньшее – «переключенных» клеток памяти (p=0,009). Терапия глюкокортикоидами ассоциировалась со снижением числа наивных В-клеток (p=0,0066) и плазмобластов (p=0,0296), но увеличением количества «переключенных» клеток памяти (p=0,0002). У пациентов с системными проявлениями (васкулит, интерстициальное поражение легких) выявлен рост числа дважды негативных В-клеток памяти (p=0,028).Заключение. Полученные данные подчеркивают нарушение распределения В-лимфоцитов при БШ и их потенциал для стратификации пациентов и выбора оптимальной терапии.

An altered distribution of peripheral B cells is a marker of B cell hyperactivation in Sjögren’s disease (SjD).Objective: to determine the relationship between the levels of various peripheral blood B lymphocyte subpopulations and the clinical and laboratory manifestations of SjD.Material and methods. The study included 103 patients with SjD (main group) and 31 healthy donors (control group). The diagnosis of SjD was established based on the 2016 ACR/EULAR criteria; all patients underwent a complete clinical and laboratory examination. B lymphocyte subpopulations were analyzed by flow cytometry. The following were assessed: CD19+ B cells, CD19+CD27+ memory B cells, memory B cells with an unswitched immunoglobulin phenotype (“unswitched”, CD19+IgD+CD27+), memory B cells with a switched immunoglobulin phenotype (“switched”, CD19+IgD-CD27+), naive B cells (CD19+IgD+CD27-), double-negative memory B cells (CD19+IgD-CD27-), transitional B cells (CD19+IgD+CD10+CD38+), plasmablasts (CD19+CD38+++IgD-CD27+), and plasma cells (CD19+CD38+). Statistical analysis was performed using GraphPad Prism 8.Results and discussion. Compared with healthy donors, patients with SjD showed a decrease in the number of CD19+ B cells (p=0.0089) and CD27+ memory cells (p=0.018), and an increase in the number of plasmablasts (p<0.0001). Correlation analysis demonstrated an association of IgG levels with increased plasmablast counts (r=0.76, p=0.0038) and plasma cell counts (r=0.81, p=0.0001), as well as an inverse correlation with the number of memory B cells (r=-0.72, p=0.006). Patients with elevated IgG concentrations (>16 mg/L) had a higher number of naïve B cells (p=0.0047) and a lower number of “switched” memory cells (p=0.009). Glucocorticoid therapy was associated with a decrease in the number of naive B cells (p=0.0066) and plasmablasts (p=0.0296), but an increase in the number of “switched” memory cells (p=0.0002). In patients with systemic manifestations (vasculitis, interstitial lung disease), an increase in the number of double-negative memory B cells was detected (p=0.028).Conclusion. The obtained data highlight the altered distribution of B-lymphocytes in SjD and their potential for patient stratification and selection of optimal therapy.

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The authors declare that there are no conflicts of interest present.