Autoantibody subclass predominance is not driven by aberrant class switching or impaired B cell development

Laurent M. Paardekooper, Yvonne E. Fillié-Grijpma, Alita J. van der Sluijs-Gelling, Mihaela Zlei, Remco van Doorn, Maarten H. Vermeer, Manuela Paunovic, Maarten J. Titulaer, Silvère M. van der Maarel, Jacques J.M. van Dongen, Jan J. Verschuuren, Maartje G. Huijbers*, T2B Consortium

*Corresponding author for this work

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Abstract

A subset of autoimmune diseases is characterized by predominant pathogenic IgG4 autoantibodies (IgG4-AID). Why IgG4 predominates in these disorders is unknown. We hypothesized that dysregulated B cell maturation or aberrant class switching causes overrepresentation of IgG4+ B cells and plasma cells. Therefore, we compared the B cell compartment of patients from four different IgG4-AID with two IgG1-3-AID and healthy donors, using flow cytometry. Relative subset abundance at all maturation stages was normal, except for a, possibly treatment-related, reduction in immature and naïve CD5+ cells. IgG4+ B cell and plasma cell numbers were normal in IgG4-AID patients, however they had a (sub)class-independent 8-fold increase in circulating CD20-CD138+ cells. No autoreactivity was found in this subset. These results argue against aberrant B cell development and rather suggest the autoantibody subclass predominance to be antigen-driven. The similarities between IgG4-AID suggest that, despite displaying variable clinical phenotypes, they share a similar underlying immune profile.

Original languageEnglish
Article number109817
JournalClinical Immunology
Volume257
DOIs
Publication statusPublished - Dec 2023

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