Persistence of Autoreactive IgA-Secreting B Cells Despite Multiple Immunosuppressive Medications Including Rituximab

Persistence of Autoreactive IgA-Secreting B Cells Despite Multiple Immunosuppressive Medications Including Rituximab.

IMPORTANCE Immunobullous diseases mediated by IgA are often difficult to manage, but to date no mechanism has been proposed. Rituximab is an anti-CD20 monoclonal antibody that has demonstrated good efficacy in the treatment of refractory mucous membrane pemphigoid. However, not all cases of mucous membrane pemphigoid respond to rituximab. Herein we present a case of treatment-refractory mucous ...

Scarcity of autoreactive human blood IgA+ memory B cells

Class-switched memory B cells are key components of the "reactive" humoral immunity, which ensures a fast and massive secretion of high-affinity antigen-specific antibodies upon antigenic challenge. In humans, IgA class-switched (IgA+ ) memory B cells and IgA antibodies are abundant in the blood. Although circulating IgA+ memory B cells and their corresponding secreted immunoglobulins likely po...

Intestinal Extravasation of IgA Antibody-Secreting Cells

Immunosuppressive Medications.

Immunosuppressive agents are commonly used in the nephrologist's practice in the treatment of autoimmune and immune-mediated diseases and transplantation, and they are investigational in the treatment of AKI and ESRD. Drug development has been rapid over the past decades as mechanisms of the immune response have been better defined both by serendipity (the discovery of agents with immunosuppres...

Redemption of autoreactive B cells.

Autoreactive antibodies can be pathogenic in a myriad of diseases. Consequently, the adaptive immune system actively removes or inactivates self-reactive B cells, while promoting the survival of B cells that recognize exogenous antigens, including microbial pathogens (1, 2). These physiological mechanisms of immune tolerance are often defective in autoimmune diseases (3, 4), and much effort is ...