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However, its effects on immune regulatory B and T cells (Bregs and Tregs) has not been fully explored. Thirty-one RA patients treated with abatacept for\u2009\u2265\u20096\u00a0months along with 31 RA patients treated with other modalities as well as 30 healthy controls were recruited. Of these 62 RA patient, 49 (79%) were females with a mean age of 54\u2009\u00b1\u200912\u00a0years and disease duration of 10\u2009\u00b1\u20096\u00a0years. The blood levels of Tregs and Bregs and their production of immunosuppressive cytokines, were determined using FACS analysis and Luminex Multiplex assay. Treatment with abatacept significantly enhanced the blood level of IL-35\n                    <jats:sup>+<\/jats:sup>\n                    IL-10\n                    <jats:sup>+<\/jats:sup>\n                    Bregs (P\u2009=\u20090.0007). Their levels were higher in the blood of remitted patients (DAS28-CRP\u2009&lt;\u20092.6) compared to the unremitted ones (P\u2009=\u20090.0173), 6\u00a0months following abatacept treatment initiation. Moreover, abatacept treatment significantly enhanced the blood levels of LAG3\n                    <jats:sup>+<\/jats:sup>\n                    conventional and unconventional Tregs of RA patients. This increase in the blood levels of Bregs and Tregs was accompanied with an elevated serum level of IL-35 and IFN-\u03b2 in abatacept-treated patients. Therefore, Abatacept efficiency to achieve remittance in RA could be attributed, in part, to its ability to enhance immune regulatory cells, especially IL-35\n                    <jats:sup>+<\/jats:sup>\n                    IL-10\n                    <jats:sup>+<\/jats:sup>\n                    Bregs.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-83615-0","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T06:03:49Z","timestamp":1615442629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Abatacept enhances blood regulatory B cells of rheumatoid arthritis patients to a level that associates with disease remittance"],"prefix":"10.1038","volume":"11","author":[{"given":"Maha Fahad","family":"Alenazy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Saheb Sharif-Askari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Omair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad S.","family":"El-Wetidy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha A.","family":"Omair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussam","family":"Mitwalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Al-Muhsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abeer","family":"Al-Masri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qutayba","family":"Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabih","family":"Halwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"83615_CR1","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1084\/jem.174.3.561","volume":"174","author":"PS Linsley","year":"1991","unstructured":"Linsley, P. 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