B-Cells and BAFF in Primary Antiphospholipid Syndrome, Targets for Therapy?

Lucas L. van den Hoogen, Radjesh J. Bisoendial*

*Corresponding author for this work

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Abstract

Primary antiphospholipid syndrome (PAPS) is a systemic autoimmune disease characterized by thrombosis, pregnancy morbidity, and the presence of antiphospholipid antibodies (aPL). Anticoagulants form the mainstay of treatment in PAPS. A growing number of studies suggest a previously underappreciated role of the immune system in the pathophysiology of PAPS. Although B-cells are strongly implicated in the pathophysiology of other autoimmune diseases such as systemic lupus erythematosus (SLE), little is known about the role of B-cells in PAPS. Shifts in B-cell subsets including increases in plasmablasts and higher levels of BAFF are present in patients with PAPS. However, while treatment with rituximab and belimumab may ameliorate thrombotic and non-thrombotic manifestations of PAPS, these treatments do not reduce aPL serum levels, suggesting that B-cells contribute to the pathophysiology of APS beyond the production of autoantibodies.

Original languageEnglish
Article number18
JournalJournal of Clinical Medicine
Volume12
Issue number1
DOIs
Publication statusPublished - 20 Dec 2023

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