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. (27th July 2022) - Daneshvar, Elham
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.