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Impact of anti-interleukin-6 receptor blockade on circulating T and B cell subsets in patients with systemic lupus erythematosus
Annals of Rheumatic Diseases, 08/09/2012
Shirota Y et al. – In vivo blockade of the interleukin–6 receptor decreases lymphocyte activation and restores B and T cell homoeostasis by either blocking differentiation and/or trafficking in patients with systemic lupus erythematosus and leads to normalisation of the abnormal B and T cell subsets seen at baseline.
Methods- Fifteen patients with SLE with mild-to moderate disease activity were treated with biweekly infusions of tocilizumab, a humanised anti-IL-6 receptor monoclonal antibody for 12 weeks.
- Lymphocyte subsets (analysed by flow cytometry) and serum immunoglobulin levels were compared at baseline and at weeks 6 and 12.
- Tocilizumab decreased activated T and B cells, the frequency of CD27highCD38highIgD- plasmablasts/plasma cells and IgD-CD27+ post-switched memory B cells as well as IgG+ memory B cell, whereas it increased the frequency of IgD+CD27- antigen-inexperienced B cells.
- Among antigen-inexperienced IgD+CD27- B cells, CD38low mature naive B cells increased significantly and CD38IntermediateCD5+ pre-naive B cells showed a decreasing trend, whereas CD38highCD5+ transitional type 1 B cells did not change.
- Most of the changes occurred in patients who had abnormal values at baseline.
- IgG, IgA, IgG1 and IgG3 serum levels decreased albeit within the normal range.
- The frequency of CD4+CD45RA+CCR7+ naïve T cells increased.