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The subsets were compared across disease states, including lupus low disease activity state (LLDAS), active disease, and clinical flare. Diagnostic performance was evaluated using logistic regression and receiver operating characteristic analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with HCs, patients with cSLE exhibited reduced unswitched memory B cells and expanded pathogenic subsets, including double-negative (DN) B cells, age-associated B cells (ABCs), short-lived plasma cells (SLPCs), and long-lived plasma cells (LLPCs) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). LLPCs showed the strongest disease association [area under the curve (AUC)\u2009=\u20090.855] and a combined model further improved discrimination (AUC\u2009=\u20090.936). Active disease was characterized by expanded DN B cells, ABCs, SLPCs, and LLPCs (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). Clinical flare involved selective enrichment of ABCs, DN B cells, and plasma cells without further increase in total B cells. Of note, LLPCs remained elevated in LLDAS compared with HCs (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). ABCs were negatively correlated with complement C3 levels (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u2009\u2212\u20090.26,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>cSLE is characterized by distinct peripheral B-cell immunophenotypes across different clinical states, marked by expansion of ABCs and plasma-cell populations. Persistent LLPC enrichment during clinical quiescence suggests incomplete immunological restoration and may contribute to disease heterogeneity and relapse susceptibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12519-026-01082-x","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:36:30Z","timestamp":1788276990000},"page":"910-921","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct peripheral B-cell immunophenotypes define clinical heterogeneity in childhood-onset systemic lupus erythematosus"],"prefix":"10.1007","volume":"22","author":[{"given":"Li-Yun","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Zhen","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-141X","authenticated-orcid":false,"given":"Xiao-Chuan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"1082_CR1","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/s2352-4642(24)00172-x","volume":"8","author":"S Gao","year":"2016","unstructured":"Gao S, Yu Z, Ma X, Sun J, Ren A, Gao S, et al. 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Written informed consent to participate in the study was obtained from all participants or their parents\/legal guardians (in the case of children under 16) prior to enrollment.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this work, the authors used AI-assisted tools solely for language editing, grammar checking, and improving the readability of the manuscript. All scientific content, study design, data collection, data analysis, interpretation of the results, and figure preparation were conceived, performed, and verified entirely by the authors without the use of generative AI. After using these tools, the authors carefully reviewed and revised the manuscript and take full responsibility for the accuracy, integrity, and content of the final published work.","order":3,"name":"Ethics","label":"Declaration of generative AI and AI-assisted technologies in the writing process","group":{"name":"EthicsHeading","label":"Declarations"}}]}}