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Autoreactive B cells in rheumatoid arthritis include mainly activated CXCR3+ memory B cells and plasmablasts
Sanne Reijm, Joanneke C. Kwekkeboom, Nienke J. Blomberg, Jolien Suurmond, Diane van der Woude, René E.M. Toes, Hans U. Scherer
Sanne Reijm, Joanneke C. Kwekkeboom, Nienke J. Blomberg, Jolien Suurmond, Diane van der Woude, René E.M. Toes, Hans U. Scherer
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Research Article Immunology

Autoreactive B cells in rheumatoid arthritis include mainly activated CXCR3+ memory B cells and plasmablasts

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Abstract

Many autoimmune diseases (AIDs) are characterized by the persistence of autoreactive B cell responses, which have been directly implicated in disease pathogenesis. How and why these cells are generated or how they are maintained for years is largely unknown. Rheumatoid arthritis (RA) is among the most common AIDs and is characterized by autoantibodies recognizing proteins with posttranslational modifications (PTMs). This PTM-directed autoreactive B cell compartment is ill defined. Here, we visualized the B cell response against the three main types of PTM antigens implicated in RA by spectral flow cytometry. Our results showed extensive cross-reactivity of PTM-directed B cells against all three PTM antigens (citrulline, homocitrulline, and acetyllysine). Unsupervised clustering revealed several distinct memory B cell (mBC) populations. PTM-directed cells clustered with the most recently activated class-switched mBC phenotype, with high CD80, low CD24, and low CD21 expression. Notably, patients also harbored large fractions of PTM-directed plasmablasts (PBs). Both PTM-directed mBCs and PBs showed high expression of CXCR3, a receptor for chemokines present in abundance in arthritic joints. Together, our data provide detailed insight into the biology of B cell autoreactivity and its remarkable, seemingly exhaustless persistence in a prominent human AID.

Authors

Sanne Reijm, Joanneke C. Kwekkeboom, Nienke J. Blomberg, Jolien Suurmond, Diane van der Woude, René E.M. Toes, Hans U. Scherer

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Figure 4

Phenotypic characteristics of PTM-directed B cells.

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Phenotypic characteristics of PTM-directed B cells.
(A) Normalized MFIs ...
(A) Normalized MFIs of CD80, CD86, and Ki-67 in 3 switched memory clusters and of TT-directed and PTM-directed B cells within these clusters. (B) Normalized MFI of CCR9 in the 3 switched memory clusters and TT-directed and PTM-directed B cells within these clusters. Normalized MFI of CXCR3 (C) in the 3 switched memory clusters and (D) in the 3 PB clusters, including TT-directed and PTM-directed B cells within these clusters. Differences in CXCR3 expression were statistically tested with Wilcoxson’s signed-rank test. In all plots, each dot represents 1 RA patient, and black lines represent medians. Only those PTM- and TT-directed B cells that were present in 1 of the 3 switched memory clusters (A–C) or 1 of the 3 PB clusters (D) were included in the analysis. Donors with fewer than 10 PTM- or TT-directed B cells within the analyzed clusters were excluded from the respective analysis.

Copyright © 2026 American Society for Clinical Investigation
ISSN 2379-3708

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