Elevated Serum Level of B-Cell Activating Factor (Baff) After Rituximab Therapy in Pemphigus Vulgaris Patients Suggests a Possible Therapeutic Efficacy of B-Cell Depletion Therapies Combined With Anti-Baff Agents Publisher Pubmed



Daneshvar E¹ ; Tavakolpour S^{1, 2} ; Mahmoudi H^{1, 3} ; Daneshpazhooh M^{1, 3} ; Teimourpour A¹ ; Aslani S⁴ ; Balighi K^{1, 3}
Source: International Journal of Dermatology Published:2023

Abstract

Background: Rituximab is widely used for treatment of pemphigus patients. B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) play key roles in B cell survival, maturation, and differentiation. Here, the effect of rituximab on BAFF and APRIL in patients with pemphigus vulgaris (PV) was studied. Methods: Fifty PV cases and 56 healthy individuals were recruited. Patients received rituximab for a period of 6 months. The levels of BAFF and APRIL were measured in the serum samples. The frequency of CD19+ B cells was measured by flow cytometry. Results: The level of BAFF was significantly higher in the patients at the baseline level than controls (P = 0.0005). The level of BAFF was significantly higher at the 3rd month follow-up compared to the baseline (P = 0.033). There was a significant increase in the BAFF level at the 6th month follow-up compared to baseline (P = 0.0134). There was no significant difference in the CD19+ B cells/total lymphocytes ratio in the PV patients between the 3rd and 6th month follow-ups. Conclusions: Elevated BAFF in the sera could be associated with PV immunopathogenesis. Inhibition of BAFF after rituximab therapy might interfere with repopulation of B cells and confer a therapeutic approach in PV. © 2022 the International Society of Dermatology.