{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:51:30Z","timestamp":1790373090133,"version":"4.1.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2015,2,16]],"date-time":"2015-02-16T00:00:00Z","timestamp":1424044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100008052","name":"Alfonso Martin Escudero Foundation, Madrid, Spain","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008052","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,2,16]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Autoantibodies inhibiting the activity of the metalloproteinase, ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), underlie the pathogenesis of thrombotic thrombocytopenic purpura (TTP). Rituximab (RTX) combined with plasma-exchange (PEX) is an effective treatment in TTP. Patients can remain in remission for extended periods following PEX\/RTX, and this is associated with continuing reduction in antibodies to ADAMTS13. Factors controlling B cell differentiation to autoantibody production, including stimulation through the B cell receptor and interactions with the B cell-activating factor (BAFF), may thus impact length of remission. In this cross-sectional study, we measured naive and memory B cell phenotypes [using CD19\/immunoglobulin (Ig)D\/CD27] following PEX\/RTX treatment in TTP patients at B cell return (n = 6) and in 12 patients in remission 10\u201368 months post-RTX. We also investigated relationships among serum BAFF, soluble CD23 (sCD23\u2013 a surrogate measure of acquiring B memory (CD27+) phenotype) and BAFF receptor (BAFF-R) expression. At B cell return after PEX\/RTX, naive B cells predominated and BAFF-R expression was reduced compared to healthy controls (P &amp;lt; 0\u00b7001). In the remission group, despite numbers of CD19+ B cells within normal limits in most patients, the percentage and absolute numbers of pre-switch and memory B cells remained low, with sCD23 levels at the lower end of the normal range. BAFF levels were correlated inversely with BAFF-R expression and time after therapy. In conclusion, the long-term effects of RTX therapy in patients with TTP included slow regeneration of memory B cell subsets and persistently reduced BAFF-R expression across all B cell subpopulations. This may reflect the delay in selection and differentiation of potentially autoreactive (ADAMTS13-specific) B cells, resulting in relatively long periods of low disease activity after therapy.<\/jats:p>","DOI":"10.1111\/cei.12472","type":"journal-article","created":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T04:26:18Z","timestamp":1414038378000},"page":"414-425","source":"Crossref","is-referenced-by-count":23,"title":["Effect of rituximab on B cell phenotype and serum B cell-activating factor levels in patients with thrombotic thrombocytopenic purpura"],"prefix":"10.1093","volume":"179","author":[{"given":"E","family":"Becerra","sequence":"first","affiliation":[{"name":"Department of Rheumatology, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M A","family":"Scully","sequence":"additional","affiliation":[{"name":"Department of Haematology, University College London, London, 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