Abstract
Background Pentraxin3 (PTX3) is overexpressed in kidneys of patients developing lupus nephritis (LN). Active LN is associated with reduced anti-PTX3 antibodies. However, abnormalities of B cell differentiation against PTX3 have not been characterized in systemic lupus erythematosus (SLE). The aim of our study is to characterize PTX3-specific (PTX3+) B cells in peripheral blood of SLE patients with or without LN and healthy donors (HD). Methods SLE patients without LN, biopsy-proven LN and matched HD were analyzed. Active LN was defined as proteinuria >0.5 g/day or CrCl Results Initially, a flow cytometry based assay to identify PTX3 +B cells was developed by demonstrating simultaneous binding of PTX3-Cy5 and PTX3-PE. Specificity of B cells was validated by blocking experiments using unlabeled PTX3 (figure 1). We could identify circulating PTX3 +B cells in HD and patients. Notably, LN patients showed a significantly diminished number of PTX3 +B cells (SLE vs. LN p=0.033; HD vs. LN p=0.008). This decrease was identified in naive and memory B cell compartments (naive: SLE vs. LN p=0.028; HD vs. LN p=0.0001; memory: SLE vs. LN p=0.038, HD vs. LN p=0.011) (figure 2). Conclusions Decreased PTX3 +B cells in LN within the naive and memory compartment suggest their negative selection at early stages of B cell development potentially related to a decreased regulatory function. PTX3 +B cells could candidate for autoantigen-defined regulatory B cells as a striking abnormality of LN patients
Highlights
Pentraxin3 (PTX3) is overexpressed in kidneys of patients developing lupus nephritis (LN)
Abnormalities of B cell differentiation against PTX3 have not been characterized in systemic lupus erythematosus (SLE)
Peripheral B cells were analyzed for direct PTX3 binding by flow cytometry using PTX3 labeled with cyanine 5 (Cy5) and phycoerythrin (PE)
Summary
Pentraxin3 (PTX3) is overexpressed in kidneys of patients developing lupus nephritis (LN). Abstract 221 Figure 1 Forest plot showing correlation of HCQ blood levels with A) Assessed Adherence B) SLEDAI scores Findings support the clinical utility of measuring HCQ levels in SLE patients.
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