Differential B- and T-cell activation in Wegener’s granulomatosis☆,☆☆,★
Section snippets
Patients and clinical parameters
Thirty-three consecutive patients (22 men and 11 women; mean age, 55 years; range, 19 to 86 years) who fulfilled the classification criteria of the American College of Rheumatology for the diagnosis of WG18 were included in this cross-sectional study. All patients had ANCA with specificity for proteinase 3 at diagnosis. Eight of the 33 patients were studied at first examination of the disease. All other patients were diagnosed 33 months or longer (mean, 103 months; range, 33 to 256 months)
Clinical parameters
Serum titers of ANCA, as determined by IIF, are shown in Table I. Anti-PR3 ANCA levels, as measured by direct ELISA, were significantly higher in patients with active WG than in patients with quiescent disease (P < .005; Fig 1).
DISCUSSION
In this study we investigated the relation between cellular and humoral immunity in WG in relation to disease activity and the interrelationship of B- and T-cell activation. We found a differential activation pattern of lymphocytes where B-cell activation correlated with active disease, whereas increased T-cell activation persisted during complete remission.
CD38 was used as a marker of B-cell activation and differentiation.27 CD19+/CD38bright, blast-like B cells were present at a higher
Acknowledgements
The authors thank G. Mesander for valuable help with flow cytometry and Dr P. C. Limburg for helpful suggestions and criticism concerning this work.
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Supported by the European Community “Human Capital and Mobility,” grant ERBCHBGCT940627, and by the Dutch Kidney Foundation, grant C97.1663.
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Reprint requests: Eliane R. Popa, MSc, Department of Clinical Immunology, University Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
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