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Letter response
Response to letter by Aramugakani et al We thank Aramugakani et al1 for their critical reading of our Editorial2 accompanying Cheng et al’s3 paper on the role of long-lived plasma cells (PCs) in driving murine lupus nephritis. First, we obviously share—and have explicitly mentioned —the safety issues related to long-lived PC depletion, in particular a possible high infection rate. Second, our purpose was not to question the effects of rituximab on anti-dsDNA production in active lupus patients, in particular when complete B cell depletion is achieved,4 nor the importance of targeting plasmablasts and short-lived PCs in acute lupus. Rather, we stressed that long-lived PCs, including those homed in previously injured tissues, may well be responsible for relapses (sometimes after long periods of clinical and serological inactivity). In this respect, successful targeting of these cells may potentially offer a cure, as could be the case with haematopoietic stem cell transplantation. Finally, we agree that combination (or sequential) therapy with agents targeting plasmablasts/short-lived PCs and long-lived PCs would make sense from a theoretical viewpoint, with the obvious caveats regarding infections.
2
Pôle de Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium 3 Service de Rhumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium Correspondence to Dr Gianfranco Ferraccioli, Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, School of Medicine, CIC-Via Moscati 31,00168, Rome, Italy; [email protected] Competing interests None. Provenance and peer review Commissioned; internally peer reviewed. To cite Ferraccioli G, Houssiau FA. Ann Rheum Dis 2014;73:e21. Accepted 2 January 2014 Published Online First 30 January 2014
▸ http://dx.doi.org/10.1136/annrheumdis-2013-205096 Ann Rheum Dis 2014;73:e21. doi:10.1136/annrheumdis-2013-205128
REFERENCES 1 2 3
1
2,3
Gianfranco Ferraccioli, Frédéric A Houssiau
1 Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy
Ann Rheum Dis April 2014 Vol 73 No 4
4
Arumugakani G, Vital EM, Md Yusof MY, et al. Which B-cell subset should we target in lupus? by Ferraccioli and Houssiau. Ann Rheum Dis 2014;73:e20. Ferraccioli G, Houssiau FA. Which B-cell subset should we target in lupus. Ann Rheum Dis 2013;72:1891–2. Cheng Q, Mumtaz IM, Khodadadi L, et al. Autoantibodies from long-lived ‘memory’ plasma cells of NZB/W mice drive immune complex nephritis. Ann Rheum Dis 2013;72:2011–17. Vital EM, Dass S, Buch MH, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum 2011;63:3038–47.
e21
Downloaded from ard.bmj.com on September 26, 2014 - Published by group.bmj.com
Response to letter by Aramugakani et al Gianfranco Ferraccioli and Frédéric A Houssiau Ann Rheum Dis 2014 73: e21 originally published online January 30, 2014
doi: 10.1136/annrheumdis-2013-205128
Updated information and services can be found at: http://ard.bmj.com/content/73/4/e21.full.html
These include:
References
This article cites 3 articles, 2 of which can be accessed free at: http://ard.bmj.com/content/73/4/e21.full.html#ref-list-1
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Articles on similar topics can be found in the following collections Connective tissue disease (3650 articles) Immunology (including allergy) (4340 articles) Renal medicine (178 articles)
Notes
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Letter response
Response to letter by Aramugakani et al We thank Aramugakani et al1 for their critical reading of our Editorial2 accompanying Cheng et al’s3 paper on the role of long-lived plasma cells (PCs) in driving murine lupus nephritis. First, we obviously share—and have explicitly mentioned —the safety issues related to long-lived PC depletion, in particular a possible high infection rate. Second, our purpose was not to question the effects of rituximab on anti-dsDNA production in active lupus patients, in particular when complete B cell depletion is achieved,4 nor the importance of targeting plasmablasts and short-lived PCs in acute lupus. Rather, we stressed that long-lived PCs, including those homed in previously injured tissues, may well be responsible for relapses (sometimes after long periods of clinical and serological inactivity). In this respect, successful targeting of these cells may potentially offer a cure, as could be the case with haematopoietic stem cell transplantation. Finally, we agree that combination (or sequential) therapy with agents targeting plasmablasts/short-lived PCs and long-lived PCs would make sense from a theoretical viewpoint, with the obvious caveats regarding infections.
2
Pôle de Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium 3 Service de Rhumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium Correspondence to Dr Gianfranco Ferraccioli, Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, School of Medicine, CIC-Via Moscati 31,00168, Rome, Italy; [email protected] Competing interests None. Provenance and peer review Commissioned; internally peer reviewed. To cite Ferraccioli G, Houssiau FA. Ann Rheum Dis 2014;73:e21. Accepted 2 January 2014 Published Online First 30 January 2014
▸ http://dx.doi.org/10.1136/annrheumdis-2013-205096 Ann Rheum Dis 2014;73:e21. doi:10.1136/annrheumdis-2013-205128
REFERENCES 1 2 3
1
2,3
Gianfranco Ferraccioli, Frédéric A Houssiau
1 Institute of Rheumatology and Affine Sciences, Catholic University of the Sacred Heart, School of Medicine, Rome, Italy
Ann Rheum Dis April 2014 Vol 73 No 4
4
Arumugakani G, Vital EM, Md Yusof MY, et al. Which B-cell subset should we target in lupus? by Ferraccioli and Houssiau. Ann Rheum Dis 2014;73:e20. Ferraccioli G, Houssiau FA. Which B-cell subset should we target in lupus. Ann Rheum Dis 2013;72:1891–2. Cheng Q, Mumtaz IM, Khodadadi L, et al. Autoantibodies from long-lived ‘memory’ plasma cells of NZB/W mice drive immune complex nephritis. Ann Rheum Dis 2013;72:2011–17. Vital EM, Dass S, Buch MH, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum 2011;63:3038–47.
e21
Downloaded from ard.bmj.com on September 26, 2014 - Published by group.bmj.com
Response to letter by Aramugakani et al Gianfranco Ferraccioli and Frédéric A Houssiau Ann Rheum Dis 2014 73: e21 originally published online January 30, 2014
doi: 10.1136/annrheumdis-2013-205128
Updated information and services can be found at: http://ard.bmj.com/content/73/4/e21.full.html
These include:
References
This article cites 3 articles, 2 of which can be accessed free at: http://ard.bmj.com/content/73/4/e21.full.html#ref-list-1
Email alerting service
Topic Collections
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Articles on similar topics can be found in the following collections Connective tissue disease (3650 articles) Immunology (including allergy) (4340 articles) Renal medicine (178 articles)
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions
To order reprints go to: http://journals.bmj.com/cgi/reprintform
To subscribe to BMJ go to: http://group.bmj.com/subscribe/
