Treatment

ASC-Directed Therapy Examined in Treatment of Refractory LN

In newly published research, investigators set out to characterize kidney and urine antibody-secreting cells (ASC) of patients with active lupus nephritis (LN) before and after induction therapy.

They performed anti-CD138 staining of kidney biopsy samples to reveal ASC in patients with biopsy-proven active LN. The staining process showed a correlation between the total number of kidney CD138+ ASC in 46 patients with untreated LN, with a low estimated glomerular filtration rate (eGFR) and tubulointerstitial damage. The researchers used a gene set allowed them to study ASC maturation from plasmablast to long-lived plasma cells.

“We quantified urine ASC from untreated LN patients at diagnosis and after 6 months of prospective follow up during induction therapy,” the authors wrote. “Most kidney ASC from 3 untreated patients had a plasmablast molecular signature, contrasting with ASC from 4 patients refractory to immunosuppressant drugs that expressed long-lived plasma cells genes and clustered with long-lived bone marrow plasma cells from 2 healthy donors.”

The investigators detected some urine ASC with plasmablast signature among patients with untreated LN. “The presence of urine ASC at 6 months was associated with treatment failure.”

 

-Angelique Platas

 

Reference:

Crickx E, Tamirou F, Huscenot T. Evolution of kidney antibody secreting cells molecular signature in lupus patients with active nephritis upon immunosuppressive therapy. Arthritis Rheum. Published online March 1, 2021

doi: https://doi.org/10.1002/art.41703