Mycophenolic acid counteracts B cell proliferation and plasmablast formation in patients with systemic lupus erythematosus
Arthritis Research & Therapy, 05/11/2012
Eickenberg S et al. – The thorough inhibition of B cell activation and plasma cell formation by mycophenolate mofetil (MMF) might explain the favorable outcomes of previous clinical trials in patients with systemic lupus erythematosus (SLE), since enhanced B cell proliferation is a hallmark of this disease.
Clinical and paraclinical parameters of 107 patients with SLE were recorded consecutively and analyzed retrospectively.
Patients were divided into treatment groups (MMF: n=39, azathioprine (AZA) n=30 and controls without immunosuppressive therapy n=38).
To further delineate the effect of mycophenolic acid (MPA) on naive and memory B cells in vitro assays were performed.
Although patients taking AZA flared more frequently than patients on MMF or controls, the analysis of clinical parameters did not reveal significant differences.
However, profound differences in paraclinical parameters were found.
B cell frequencies and numbers were significantly higher in patients taking MMF compared to those on AZA but lower numbers and frequencies of plasmablasts were detected compared to AZA-treated patients or controls.
Notably, MMF treatment was associated with a significantly higher frequency and number of transitional B cells as well as naive B cells compared to AZA treatment.
Differences in T cell subsets were not significant.
MPA abrogated in vitro proliferation of purified B cells completely but had only moderate impact on B cell survival.
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