{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T20:53:33Z","timestamp":1768251213358,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T00:00:00Z","timestamp":1521936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002491","name":"Bristol-Myers Squibb","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002491","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether abnormalities in B cell subsets in patients with juvenile idiopathic arthritis (<jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>) correlate with clinical features and response to treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 109 patients diagnosed as having oligoarticular <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content> or polyarticular <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content> were enrolled in the study. B cell subsets in peripheral blood and synovial fluid were analyzed by flow cytometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Switched memory B cells were significantly increased in patients compared to age\u2010matched healthy controls (<jats:italic>P<\/jats:italic> &lt; 0.0001). When patients were divided according to age at onset of <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>, in patients with early\u2010onset disease (presenting before age 6 years) the expansion in switched memory B cells was more pronounced than that in patients with late\u2010onset disease and persisted throughout the disease course. In longitudinal studies, during methotrexate (<jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content>) treatment, regardless of the presence or absence of active disease, the number of switched memory B cells increased significantly (median change from baseline 36% [interquartile range {IQR} 15, 66]). During treatment with <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> plus tumor necrosis factor inhibitors (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i), in patients maintaining disease remission, the increase in switched memory B cells was significantly lower than that in patients who experienced active disease (median change from baseline 4% [IQR \u22126, 32] versus 41% [IQR 11, 73]; <jats:italic>P<\/jats:italic> = 0.004). The yearly rate of increases in switched memory B cells was 1.5% in healthy controls, 1.2% in patients who maintained remission during treatment with <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i, 4.7% in patients who experienced active disease during treatment with <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i, and ~4% in patients treated with <jats:styled-content style=\"fixed-case\">MTX<\/jats:styled-content> alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Switched memory B cells expand during the disease course at a faster rate in <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content> patients than in healthy children. This increase is more evident in patients with early\u2010onset <jats:styled-content style=\"fixed-case\">JIA<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>i treatment inhibits this increase in patients who achieve and maintain remission, but not in\u00a0those with active disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40410","type":"journal-article","created":{"date-parts":[[2018,1,9]],"date-time":"2018-01-09T21:42:07Z","timestamp":1515534127000},"page":"606-615","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Switched Memory B Cells Are Increased in Oligoarticular and Polyarticular Juvenile Idiopathic Arthritis and Their Change Over Time Is Related to Response to Tumor Necrosis Factor 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