Divi Cornec is a French rheumatologist, currently working at the Mayo Clinic as a Research Fellow with Ulrich Specks, in collaboration with Jacques-Olivier Pers, head of the Immunology research team U1227 in Brest, France.
Since the pivotal RAVE study codirected by Dr Specks, rituximab has become the cornerstone of the treatment of many patients with ANCA-associated vasculitis. Rituximab acts by destroying a certain type of white blood cells called “B cells”, which are responsible for the production of our antibodies. Most B cells in the blood of patients with auto-immune diseases are normal, and secrete “good” antibodies (that protect against infections for example), and only a minority of their B cells are abnormal and make the autoantibodies (the ANCAs) that are associated with the disease and may cause the damage to different organs. Until now, very little is known about the differences between normal protective B cells and abnormal ANCA-producing B cells.
What this means for patients
The authors recently developed a method to recognize these ANCA-producing B cells among all other normal B cells in the blood of the patients. This method is a very promising tool. The main objective of the present research project is to determine whether the proportion of ANCA producing (PR3-specific) B cells in the blood of the patients is associated with disease activity and could predict the risk of relapse.
If this is the case, this test could be very useful to guide treatment for each individual patient, in order to avoid unnecessary immunosuppressive therapy in some patients while preventing disease relapses in patients at risk.