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Effect of biological agents on B-lymphocyte subpopulations in patients with systemic lupus erythematosus

https://doi.org/10.14412/1996-7012-2019-1-35-43

Abstract

Objective: to evaluate the effect of different biological agents (BAs), including rituximab (RTM) and belimumab (BLM) combination therapy, on B-lymphocyte subpopulations during a follow-up of patients with systemic lupus erythematosus (SLE).

Patients and methods. The investigation enrolled 64 patients with a verified diagnosis of SLE with high and moderate disease activities according to the Systemic Lupus Erythromatosus Disease Activity Index (SLEDAI)-2K scores; 47patients of them took RTM, 10 used BLM, and 7 received RTM + BLM combination therapy. Peripheral blood B-lymphocyte subpopulations were measured by multicolor flow cytofluorom-etry, using a panel of monoclonal antibodies to B-lymphocyte surface membrane markers. The results were assessed using the SLEDAI-2K scores and the British Isles Lupus Assessment Group (BILAG) index.

Results and discussion. RTM therapy led to a marked decrease in major B-lymphocyte populations, the residual cells being naXve B-cells and different memory B cell populations, the percentage of which depended on the degree of depletion after a RTM cycle. Incomplete B-lymphocyte depletion was associated with the large baseline numbers of plasma cells (PCs) (>0.2%). One year after initiation of therapy, the percentage ratio of B-lymphocyte subpopulations returned almost completely to baseline values, except the whole memory B-cellpopulation. BLM therapy resulted in a decrease in PCs and plasmablasts (PBs) to the point of their complete depletion. There were reductions in total CD19+ B-lym-phocytes and naive B lymphocytes. The use of the combination of BAs permitted the monitoring of the total B-lymphocyte population; its slower recovery was seen in patients with its complete depletion after a rituximab cycle. The therapy promoted maintenance of low concentrations of PCs and PBs, total memory B-cell and naive B-cell populations.

Conclusion. In patients with SLE, all the three therapy with BAs demonstrated a good efficiency manifested by a decrease in clinical and laboratory disease activity. The found time course of changes in B-lymphocyte subpopulations can be used for the selection of therapy and for the evaluation of its efficacy.

About the Authors

A. A. Mesnyankina
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

Anna Aleksandrovna Mesnyankina

34A, Kashirskoe Shosse, Moscow 115522



S. K. Solovyev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522



E. A. Aseeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522



A. P. Aleksankin
Research Institute of Human Morphology
Russian Federation

3, Tsyurupa St., Moscow 117418



E. N. Aleksandrova
A.S. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department of Health
Russian Federation

3 86, Shosse Entuziastov, Moscow 111123



E. L. Nasonov
Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Rheumatology

4 8, Trubetskaya St., Build 2, Moscow, 119991



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Review

For citations:


Mesnyankina AA, Solovyev SK, Aseeva EA, Aleksankin AP, Aleksandrova EN, Nasonov EL. Effect of biological agents on B-lymphocyte subpopulations in patients with systemic lupus erythematosus. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2019;13(1):35-43. https://doi.org/10.14412/1996-7012-2019-1-35-43

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)