Hershberg, U and Meng, W and Zhang, B and Haff, N and St Clair, EW and Cohen, PL and McNair, PD and Li, L and Levesque, MC and Luning Prak, ET
(2014)
Persistence and selection of an expanded B-cell clone in the setting of rituximab therapy for Sjögren's syndrome.
Arthritis Research and Therapy, 16 (1).
ISSN 1478-6354
Abstract
Introduction: Subjects with primary Sjögren's syndrome (SjS) have an increased risk of developing B-cell lymphoma and may harbor monoclonal B-cell expansions in the peripheral blood. Expanded B-cell clones could be pathogenic, and their persistence could exacerbate disease or predispose toward the development of lymphoma. Therapy with anti-CD20 (rituximab) has the potential to eliminate expanded B-cell clones and thereby potentially ameliorate disease. This study was undertaken to identify and track expanded B-cell clones in the blood of subjects with primary SjS who were treated with rituximab.Methods: To determine whether circulating B-cell clones in subjects with primary SjS emerge or remain after B cell-depleting therapy with rituximab, we studied the antibody heavy-chain repertoire. We performed single-memory B-cell and plasmablast sorting and antibody heavy-chain sequencing in six rituximab-treated SjS subjects over the course of a 1-year follow-up period.Results: Expanded B-cell clones were identified in four out of the six rituximab-treated SjS subjects, based upon the independent amplification of sequences with identical or highly similar VH, DH, and JH gene segments. We identified one SjS subject with a large expanded B-cell clone that was present prior to therapy and persisted after therapy. Somatic mutations in the clone were numerous but did not increase in frequency over the course of the 1-year follow-up, suggesting that the clone had been present for a long period of time. Intriguingly, a majority of the somatic mutations in the clone were silent, suggesting that the clone was under chronic negative selection.Conclusions: For some subjects with primary SjS, these data show that (a) expanded B-cell clones are readily identified in the peripheral blood, (b) some clones are not eliminated by rituximab, and (c) persistent clones may be under chronic negative selection or may not be antigen-driven. The analysis of sequence variation among members of an expanded clone may provide a novel means of measuring the chronicity and selection of expanded B-cell populations in humans. © 2014 Hershberg et al.; licensee BioMed Central Ltd.
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| Item Type: |
Article
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| Status: |
Published |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Hershberg, U | | | | | Meng, W | | | | | Zhang, B | | | | | Haff, N | | | | | St Clair, EW | | | | | Cohen, PL | | | | | McNair, PD | | | | | Li, L | | | | | Levesque, MC | | | | | Luning Prak, ET | | | |
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| Date: |
11 February 2014 |
| Date Type: |
Publication |
| Journal or Publication Title: |
Arthritis Research and Therapy |
| Volume: |
16 |
| Number: |
1 |
| DOI or Unique Handle: |
10.1186/ar4481 |
| Schools and Programs: |
School of Medicine > Immunology
School of Medicine > Medicine |
| Refereed: |
Yes |
| ISSN: |
1478-6354 |
| Date Deposited: |
02 Dec 2016 20:33 |
| Last Modified: |
26 Jan 2019 23:55 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/29600 |
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