Skip to main content
Journal cover image

Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis.

Publication ,  Journal Article
Unizony, S; Lim, N; Phippard, DJ; Carey, VJ; Miloslavsky, EM; Tchao, NK; Iklé, D; Asare, AL; Merkel, PA; Monach, PA; Seo, P; St Clair, EW ...
Published in: Arthritis Rheumatol
February 2015

OBJECTIVE: CD5+ B cells have been conceptualized as a possible surrogate for Breg cells. The aim of the present study was to determine the utility of CD5+ B cells as biomarkers in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). METHODS: The absolute and relative numbers (percentages) of CD5+ B cells (explanatory variables) were measured longitudinally during 18 months in 197 patients randomized to receive either rituximab (RTX) or cyclophosphamide (CYC) followed by azathioprine (AZA) for the treatment of AAV (Rituximab in ANCA-Associated Vasculitis [RAVE] trial). Outcome variables included disease activity (status of active disease versus complete remission), responsiveness to induction therapy, disease relapse, disease severity, and, in RTX-treated patients, relapse-free survival according to the percentage of CD5+ B cells detected upon B cell repopulation. RESULTS: CD5+ B cell numbers were comparable between the treatment groups at baseline. After an initial decline, absolute CD5+ B cell numbers progressively increased in patients in the RTX treatment arm, but remained low in CYC/AZA-treated patients. In both groups, the percentage of CD5+ B cells increased during remission induction and slowly declined thereafter. During relapse, the percentage of CD5+ B cells correlated inversely with disease activity in RTX-treated patients, but not in patients who received CYC/AZA. No significant association was observed between the numbers of CD5+ B cells and induction treatment failure or disease severity. The dynamics of the CD5+ B cell compartment did not anticipate disease relapse. Following B cell repopulation, the percentage of CD5+ B cells was not predictive of time to flare in RTX-treated patients. CONCLUSION: The percentage of peripheral CD5+ B cells might reflect disease activity in RTX-treated patients. However, sole staining for CD5 as a putative surrogate marker for Breg cells did not identify a subpopulation of B cells with clear potential for meaningful clinical use. Adequate phenotyping of Breg cells is required to further explore the value of these cells as biomarkers in AAV.

Duke Scholars

Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

February 2015

Volume

67

Issue

2

Start / End Page

535 / 544

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rituximab
  • Middle Aged
  • Male
  • Humans
  • Female
  • Drug Therapy, Combination
  • Double-Blind Method
  • Disease Progression
  • Cyclophosphamide
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Unizony, S., Lim, N., Phippard, D. J., Carey, V. J., Miloslavsky, E. M., Tchao, N. K., … Stone, J. H. (2015). Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol, 67(2), 535–544. https://doi.org/10.1002/art.38916
Unizony, Sebastian, Noha Lim, Deborah J. Phippard, Vincent J. Carey, Eli M. Miloslavsky, Nadia K. Tchao, David Iklé, et al. “Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis.Arthritis Rheumatol 67, no. 2 (February 2015): 535–44. https://doi.org/10.1002/art.38916.
Unizony S, Lim N, Phippard DJ, Carey VJ, Miloslavsky EM, Tchao NK, et al. Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2015 Feb;67(2):535–44.
Unizony, Sebastian, et al. “Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis.Arthritis Rheumatol, vol. 67, no. 2, Feb. 2015, pp. 535–44. Pubmed, doi:10.1002/art.38916.
Unizony S, Lim N, Phippard DJ, Carey VJ, Miloslavsky EM, Tchao NK, Iklé D, Asare AL, Merkel PA, Monach PA, Seo P, St Clair EW, Langford CA, Spiera R, Hoffman GS, Kallenberg CGM, Specks U, Stone JH. Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2015 Feb;67(2):535–544.
Journal cover image

Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

February 2015

Volume

67

Issue

2

Start / End Page

535 / 544

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Rituximab
  • Middle Aged
  • Male
  • Humans
  • Female
  • Drug Therapy, Combination
  • Double-Blind Method
  • Disease Progression
  • Cyclophosphamide