Abstract
Objective
The efficiency of B-cell depletion therapy for severe ocular cicatricial pemphigoid
(OCP) highlights the key role of B lymphocytes in the immunopathogenesis of OCP. B-cell
activating factor (BAFF) is a potent B-cell growth factor and costimulator of immunoglobulin
production. Elevated serum BAFF is associated with systemic autoimmune diseases, such
as systemic lupus erythematosus, rheumatoid arthritis and bullous pemphigoid. We hypothesize
that serum BAFF levels are also increased in patients with OCP.
Methods
Sera were collected from 30 patients with new-onset active OCP, 9 with disease in
remission, 10 with OCP relapse, and 15 healthy control individuals. An enzyme-linked
immunosorbent assay was performed to measure the concentration of serum BAFF.
Results
BAFF was significantly higher in patients with new-onset active OCP (700.8 ± 181.8
pg/mL) than in healthy control individuals (564.1 ± 133.2 pg/mL; p = 0.014). No significant difference was found between patients with OCP in remission
(585.4 ± 216.2 pg/mL) and healthy control individuals. Patients with disease relapse
treated with rituximab had an extremely high concentration of BAFF (1721.9 ± 790.8
pg/mL). Longitudinal analysis of serum BAFF from 6 patients showed that BAFF decreased
as the disease went from new onset (895.0 ± 240.8 pg/mL) to remission (625.4 ± 199.8
pg/mL; p = 0.003).
Conclusions
BAFF is involved in the active inflammation of OCP. Targeting BAFF with an antagonist
may be therapeutically beneficial for patients with refractory OCP, especially those
resistant to rituximab.
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 13,
2022
Received in revised form:
October 11,
2022
Received:
June 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
