Background/Purpose: B cell subset proportions within the B cell pool, also known as B cell signatures (BCS), reflect not only systemic lupus erythematosus (SLE) disease activity status, but also therapy effects. In this study, we evaluated whether socioeconomic-demographic, disease activity, immunologic, and treatment factors, may influence BCS in SLE patients.

Methods: Peripheral blood mononuclear cells were isolated from 37 patients who fulfilled the ACR Classification criteria for SLE, and from 14 healthy individuals. Socioeconomic-demographic (age, ethnicity, primary language, highest level of education, health insurance), disease activity (duration, SLEDAI score), and immunologic variables (parity, anti-dsDNA), as well as type of treatment received (standard of care therapy (SCT) vs Belimumab), were collected. B cell subsets (nonmemory =T1, T2, Follicular Mature (FM); memory =IgM, IgM/IgD, IgD, switched) were identified via flow cytometry. Student T-Test, one-way ANOVA, Dunnett’s and Tukey’s post-hoc tests were used for statistical analyses.

Results: Ethnicity, race, age, level of education, and primary language do not alter B cell subsets in SLE patients. SLE patients with either HMO-private or federal health insurance have less T1 subsets as compared to those with HMO-public insurance (p = 0.0004). SLE patients with either HMO-private or federal insurance have more FM subsets as compared to SLE patients with HMO-public insurance (p = 0.0041). Both T2 (p = 0.0030) and IgD (p = 0.0389) subsets from SLE patients with SLEDAI score 1-5 were lower as compared to healthy controls. Patients with SLE duration of disease from 0-5 or 6-10 years have lower T2 subsets as compared to healthy controls (p = 0.0020). Patients with SLE duration from 0-5 years have higher FM subsets as compared to healthy controls (p = 0.036). SLE patients have lower proportions of T2 subsets, irrespective of the presence or absence of anti-dsDNA, as compared to healthy controls (p = 0.0052). The presence of anti-dsDNA is associated with lower IgD subsets as compared to healthy controls (p = 0.0204). SLE patients with children have lower T1 (p = 0.0326) and higher FM (p = 0.0448) subsets as compared to those with none. SLE patients treated with SCT have lower T1 subsets as compared to those treated with both SCT and Belimumab (p = 0.0303). SLE patients treated with either SCT or Belimumab have lower T2 cells as compared to healthy controls (p = 0.0102). SLE patients treated with SCT have lower switched B cells as compared to those treated with both SCT and Belimumab (p = 0.0064). SLE patients treated with both SCT and Belimumab have higher switched B cells as compared to healthy controls (p = 0.0064).

Conclusion: To our knowledge, this is the first study showing that socioeconomic-demographic, disease activity, and immunologic variables are associated with unique B cell profiles in SLE patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/socioeconomic-demographic-disease-activity-treatment-and-immunologic-variables-affect-b-cell-subtypes-in-systemic-lupus-erythematosus/