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. 2015 Sep;74(9):1784-6.
doi: 10.1136/annrheumdis-2014-206756. Epub 2015 Apr 30.

Gleaning relapse risk from B cell phenotype: decreased CD5+ B cells portend a shorter time to relapse after B cell depletion in patients with ANCA-associated vasculitis

Donna O Bunch  1 , Carmen E Mendoza  1 , Lydia T Aybar  1 , Elizabeth S Kotzen  1 , Kerry R Colby  1 , Yichun Hu  1 , Susan L Hogan  1 , Caroline J Poulton  1 , John L Schmitz  2 , Ronald J Falk  1 , Patrick H Nachman  1 , William F Pendergraft  1 , JulieAnne G McGregor  1
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Gleaning relapse risk from B cell phenotype: decreased CD5+ B cells portend a shorter time to relapse after B cell depletion in patients with ANCA-associated vasculitis

Donna O Bunch et al. Ann Rheum Dis. 2015 Sep.
No abstract available

Keywords: Autoimmune Diseases; B cells; Disease Activity; Granulomatosis with polyangiitis; Systemic vasculitis.

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Conflict of interest statement

Competing interests None declared.

Figures

Figure 1
Figure 1
Repopulation with <30% CD5+ B cells portends a shorter time to relapse than repopulation with normal levels of CD5+ B cells. (A) Gating scheme for re-analysis of clinical flow cytometry data. Whole blood was stained for a CD20 workup with the following fluorescently labelled antihuman antibodies: CD20-FITC (clone L27), CD45-PerCP (clone 2D1) and CD5-PE (clone L17F12, all from BD Biosciences, San Jose, California, USA). Cells were analysed using a FACSCanto II flow cytometer. Lymphocytes were first selected based on forward versus side scatter; CD45 was then used as a pan lymphocyte marker in combination with side scatter to identify lymphocytes in a strategy known as heterogeneous gating that is required in clinical flow cytometry core facilities. CD5+ B cells were defined as cells positive for both CD20 and CD5 as denoted by the oval gate. In samples used for this study, CD20 correlated well with CD19 expression (r2=0.98). (B) Relapse-free survival from the first dose of rituximab is depicted. Patients who repopulated with ≤30%CD5+ B cells ( formula image) relapsed sooner than patients who repopulated with >30% CD5+ B cells ( formula image; p=0.005). Open squares denote the months of follow-up for patients who did not relapse during the time of our study (n=11), with a minimum 24 months of relapse-free follow-up required. Adjusting for differences in upper respiratory involvement, the low CD5 group at B cell repopulation remained significantly associated with a shorter time to relapse from time of rituximab (p=0.002) and from time of B cell repopulation (p=0.001). (C) CD20+CD5+ B cells decrease prior to relapse. Shown is an example of a patient who repopulates with high CD5+ B cells after rituximab therapy but exhibits decreasing and then low CD5+ B cells prior to disease relapse (denoted by star).
See this image and copyright information in PMC

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