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10.1186/ar3835

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C4060361!4060361 !22571761
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suck abstract from ncbi


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pmid22571761
      Arthritis+Res+Ther 2012 ; 14 (3 ): R110
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  • Mycophenolic acid counteracts B cell proliferation and plasmablast formation in patients with systemic lupus erythematosus #MMPMID22571761
  • Eickenberg S ; Mickholz E ; Jung E ; Nofer JR ; Pavenstadt HJ ; Jacobi AM
  • Arthritis Res Ther 2012[]; 14 (3 ): R110 PMID22571761 show ga
  • INTRODUCTION: Clinical trials revealed a high efficacy of mycophenolate mofetil (MMF)in inducing and maintaining remission in patients with class III-V-lupus nephritis. Also extrarenal manifestations respond to MMF treatment. However, few attempts have been undertaken to delineate its mechanism of action in systemic lupus erythematosus (SLE) a disease characterized by enhanced B cell activation. METHODS: Clinical and paraclinical parameters of 107 patients with SLE were recorded consecutively and analyzed retrospectively. Patients were divided into treatment groups (MMF: n=39, azathioprine (AZA) n=30 and controls without immunosuppressive therapy n=38). To further delineate the effect of mycophenolic acid (MPA) on naive and memory B cells in vitro assays were performed. RESULTS: Although patients taking AZA flared more frequently than patients on MMF or controls, the analysis of clinical parameters did not reveal significant differences.However, profound differences in paraclinical parameters were found. B cell frequencies and numbers were significantly higher in patients taking MMF compared to those on AZA but lower numbers and frequencies of plasmablasts were detected compared to AZA-treated patients or controls. Notably, MMF treatment was associated with a significantly higher frequency and number of transitional B cells as well as naive B cells compared to AZA treatment. Differences in T cell subsets were not significant. MPA abrogated in vitro proliferation of purified B cells completely but had only moderate impact on B cell survival. CONCLUSIONS: The thorough inhibition of B cell activation and plasma cell formation by MMF might explain the favorable outcomes of previous clinical trials in patients with SLE, since enhanced B cell proliferation is a hallmark of this disease.
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Azathioprine/therapeutic use [MESH]
  • |B-Lymphocytes/cytology/*drug effects [MESH]
  • |Cell Proliferation/*drug effects [MESH]
  • |Female [MESH]
  • |Flow Cytometry [MESH]
  • |Humans [MESH]
  • |Immunosuppressive Agents/*therapeutic use [MESH]
  • |Lupus Erythematosus, Systemic/*drug therapy/immunology [MESH]
  • |Lymphocyte Activation/*drug effects [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Mycophenolic Acid/*therapeutic use [MESH]
  • |Plasma Cells/drug effects [MESH]
  • |Retrospective Studies [MESH]


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