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Abstract: FR-OR085

Proliferation and Changes in Cellular Signatures in Memory B Cells from Lupus Nephritis Patients Receiving Mycophenolate or Azathioprine Maintenance

Session Information

  • Lupus and Then Some
    November 08, 2019 | Location: Ballroom C, Walter E. Washington Convention Center
    Abstract Time: 05:18 PM - 05:30 PM

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Yap, Desmond Y.H., Queen Mary Hospital, Hong Kong, HONG KONG, China
  • Lee, Paul, The University of Hong Kong, Hong Kong, China
  • Tam, Cheryl, The University of Hong Kong, Hong Kong, China
  • Yam, Irene, The University of Hong Kong, Hong Kong, China
  • Yung, Susan, The University of Hong Kong, Hong Kong, China
  • Chan, Daniel Tak Mao, Queen Mary Hospital, Hong Kong, HONG KONG, China
Background

Mycophenolate mofetil (MMF) and azathioprine (AZA) are standard maintenance treatments for lupus nephritis (LN), and recent data suggested lower risk of relapse with MMF maintenance. Memory B cells have been implicated in LN relapse, and miRNA148a, BACH1, BACH2 and PAX5 can regulate memory B cell homeostasis. The effects of MMF and AZA treatment on these memory B cell signatures remain unclear.

Methods

Memory B cells were isolated from clinically stable LN patients receiving low-dose corticosteroid and MMF (n=10) or AZA (n=9) maintenance, and the cell proliferation and intracellular miRNA148a, BACH1, BACH2 and PAX5 expressions on Day 3 after ex vivo stimulation were compared.

Results

MMF group showed lower memory B cell proliferation on Day 3 (8.5±1.2%, compared with 20.3±2.0% in AZA group, p<0.001) (Figure 1, A). MMF group also showed lower miRNA148a expression (10-fold decrease compared to health controls (HC), vs. 2-fold decrease in AZA group, p<0.001) (Figure 1, B), but higher BACH1, BACH and PAX5 expression in memory B cells (8.2±0.8, 7.2±1.8, and 7.6±1.1 fold increase compared to HC respectively, vs. 4.0±0.7, 2.9±0.6, and 3.4±0.4 fold increase in the AZA group, p<0.001, MMF vs. AZA) (Figure 1, C).

Conclusion

LN patients receiving MMF maintenance showed reduced memory B cell proliferation and a distinct cellular signature, which may account for the lower risk of relapse observed clinically.