{"doi":"10.1002/art.42388","title":"Autoreactive Plasmablasts After B Cell Depletion With Rituximab and Relapses in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis","abstract":"OBJECTIVE: Autoreactive B cells are responsible for antineutrophil cytoplasmic antibody (ANCA) production in ANCA-associated vasculitis (AAV). Rituximab (RTX) depletes circulating B cells, including autoreactive B cells. We aimed to evaluate changes and associations with relapse of the circulating autoreactive B cell pool following therapeutic B cell depletion in AAV. METHODS: Sequential flow cytometry was performed on 148 samples of peripheral blood mononuclear cells from 23 patients with proteinase 3 (PR3)-ANCA-positive AAV who were treated with RTX for remission induction and monitored after stopping therapy during long-term follow-up in a prospective clinical trial. PR3 was used as a ligand to target autoreactive PR3-specific (PR3+) B cells. B cell recurrence was considered as the first blood sample with ≥10 B cells/μl after RTX treatment. RESULTS: At B cell recurrence, PR3+ B cell frequency among B cells was higher than baseline (P < 0.01). Within both PR3+ and total B cells, frequencies of transitional and naive subsets were higher at B cell recurrence than at baseline, while memory subsets were lower (P < 0.001 for all comparisons). At B cell recurrence, frequencies of B cells and subsets did not differ between patients who experienced relapse and patients who remained in remission. In contrast, the plasmablast frequency within the PR3+ B cell pool was higher in patients who experienced relapse and associated with a shorter time to relapse. Frequencies of PR3+ plasmablasts higher than baseline were more likely to be found in patients who experienced relapse within the following 12 months compared to those in sustained remission (P < 0.05). CONCLUSION: The composition of the autoreactive B cell pool varies significantly following RTX treatment in AAV, and early plasmablast enrichment within the autoreactive pool is associated with future relapses.","journal":"Arthritis & Rheumatology","year":2022,"id":252960,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9654,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":724886,"name":"Sophie Hillion","orcid":"0000-0002-3354-0981","position":1,"is_corresponding":false},{"id":270633,"name":"Maximilian F. Konig","orcid":"0000-0001-5045-5255","position":2,"is_corresponding":false},{"id":898198,"name":"Marta Casal Moura","orcid":"0000-0001-7439-6501","position":3,"is_corresponding":false},{"id":725332,"name":"Amber M. Hummel","orcid":null,"position":4,"is_corresponding":false},{"id":389116,"name":"Eva M. Carmona","orcid":"0000-0001-9852-8396","position":5,"is_corresponding":false},{"id":575339,"name":"Tobias Peikert","orcid":null,"position":6,"is_corresponding":false},{"id":242666,"name":"Fernando C. Fervenza","orcid":"0000-0002-9952-209X","position":7,"is_corresponding":false},{"id":25204,"name":"Cees G. M. Kallenberg","orcid":null,"position":8,"is_corresponding":false},{"id":251775,"name":"Carol A. Langford","orcid":"0000-0001-9498-321X","position":9,"is_corresponding":false},{"id":5969,"name":"Peter A. Merkel","orcid":"0000-0001-9284-7345","position":10,"is_corresponding":false},{"id":61593,"name":"Paul A. Monach","orcid":"0000-0003-4937-0515","position":11,"is_corresponding":false},{"id":328460,"name":"Philip Seo","orcid":"0000-0003-3435-6737","position":12,"is_corresponding":false},{"id":251783,"name":"Robert Spiera","orcid":"0000-0003-2911-6800","position":13,"is_corresponding":false},{"id":369923,"name":"Paul Brunetta","orcid":"0009-0001-8785-7343","position":14,"is_corresponding":false},{"id":280488,"name":"E. William St. Clair","orcid":"0000-0003-1181-0650","position":15,"is_corresponding":false},{"id":256536,"name":"Kristina M. Harris","orcid":"0000-0002-6957-514X","position":16,"is_corresponding":false},{"id":25215,"name":"John H. Stone","orcid":"0000-0001-6588-9435","position":17,"is_corresponding":false},{"id":724888,"name":"Guido Grandi","orcid":"0000-0001-9724-2185","position":18,"is_corresponding":false},{"id":724889,"name":"Jacques‐Olivier Pers","orcid":"0000-0001-7287-5541","position":19,"is_corresponding":false},{"id":25214,"name":"Ulrich Specks","orcid":"0000-0002-6559-1206","position":20,"is_corresponding":false},{"id":724890,"name":"Divi Cornec","orcid":"0000-0002-9159-702X","position":21,"is_corresponding":false},{"id":270372,"name":"Alvise Berti","orcid":"0000-0002-7831-921X","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T00:24:55.325369Z","pmid":"36281741","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}