Analysis of changes in peripheral blood B lymphocyte subpopulations in patients with Sjögren’s disease

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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