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B Cell Depletion: Check the Lymph Node
Dr. Akhil Sood reports on abstract 2695 (B-cell depletion and lymphoid follicle disruption upon different B-cell depleting agents) presented at #ACR25.
https://t.co/BjgIC3Kng0 https://t.co/flfyLZYW8q
Dr. John Cush RheumNow ( View Tweet)
If you missed this pattern, you missed an autoimmune classic
What’s it? https://t.co/zO48zPCkqP
DocXus docxusofficial ( View Tweet)
The Rapidly Evolving Landscape of Cellular and Immune-based Therapies
When Henry Ford unveiled the Model T in 1908, the automobile industry was forever changed. A similar transformation is now underway in rheumatology, where cellular and immune therapies are redefining how we https://t.co/RQuVETSTG4
Dr. John Cush RheumNow ( View Tweet)
Why are vaccine Abs maintained after CAR-T
-depletion of pathogenic #Abs are dampened/eliminated
Clonal repetoire expansion
Remission=naive B cell pop'n
Reset immune system sparing memory cells
vs ?not all pathogenic cells eliminated in tissue
#ACR25 @RheumNow @ACRheum
#26S21 https://t.co/jb3dD5Ssip
Janet Pope Janetbirdope ( View Tweet)
Needle in a haystack
What T cell to target for #autoimmune diseases
T cell repetoires (TCR) not all are sequenced and many can exist to present antigens
Diff scales of approaches
Implications CAR-T
CD19
CD20
BCMA
Treg
HLAB27
etc!
#ACR25 @ACRheum @RheumNow
Alok Joglekar
#26S08 https://t.co/Qgw8Akz1xk
Links:
Janet Pope Janetbirdope ( View Tweet)
While post-CAR-T CRS might be semi-familiar for rheumatologists, ICANS is a new concept to get our heads around, and one which is far from heterogenous.
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/qX2jKMG2oB
David Liew drdavidliew ( View Tweet)
I've always (very) simplistically considered post-CAR-T CRS and HLH/MAS in the same bucket, and there certainly are substantial similarities.
It raises the obvious question - can we borrow therapies?
@CarolineDiorio @ChildrensPhila in the #ACR25 BCRC pre-meeting @RheumNow https://t.co/2HkHxpl89u
David Liew drdavidliew ( View Tweet)
@CarolineDiorio @ChildrensPhila eloquently told the #ACR25 BCRC pre-meeting about the lessons they've learned about CRS and ICANS, the major CAR-T toxicities.
Many questions still to answer, but they've also understood a lot we can learn from.
@RheumNow https://t.co/Jhk1eCLpD4
Links:
David Liew drdavidliew ( View Tweet)
Next Generation T-Cell Engager: The Future
Dr. Alfred Kim reviews abstract 0001 presented at #ACR25.
https://t.co/vmZYfmKCm8 https://t.co/PkLOs9lZ8l
Links:
Dr. John Cush RheumNow ( View Tweet)
#ACR25 Abstr#2695 Inguinal lymph node biopsies pre- and post-OBI, RTX, BLIN & CD19 CAR-T showed complete tissue depletion with CAR-T. B-cells reduced but often incomplete with protein-based depleters; OBI being the best. Still don’t agree with “immune reset” @RheumNow #ACRBest https://t.co/Sq7m9sXlLP
Links:
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Abstract 2696: Phase 1/2 study of rapidly engineered CD19 CAR T showed:
- rapid depletion of CD19 B cells w/ recovery by Day 90
- Days 180 and 360: returning B cells largely naive (CD27-IgD+)
- Interferon expression ↓ after CAR T treatment
@RheumNow #ACR25 https://t.co/FzdFbqWwtE
Links:
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Abstract 2695: Deep dive into B-cell depletion (BCD)
Lymph node biopsy pre/post tx:
🔹 CAR T: complete BCD + disrupted follicular architecture
🔹 RTX, OBI, BLIN: reduced BCD + preserved follicular architecture
✅ Complete LN depletion → drug-free remission
@RheumNow #ACR25
Akhil Sood MD, MS AkhilSoodMD ( View Tweet)
Thank you @drdavidliew & @DrLauraCoates ❤️ for highlighting our work. Super-responders (some were IS-Free) do exist with rituximab in #SLE Abstr#1525 @RheumNow https://t.co/S4mMAYInfT
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Fighting fire with butyrate 🔥🚒
♦️probiotics and prebiotics
Dr. Nisha Manek on inflammation and butyrate - it reduces gut inflamm thru the NFKB pathway
#ACR25 @RheumNow https://t.co/19XTrKn1iN
sheila RHEUMarampa ( View Tweet)
Sjögren’s, decoded by Ab -->ESSDAI domains:
• anti-SSA → glandular
• anti-Ro52 / SCL70 → biologic activity
• anti-nucleosome → pulmonary
• anti-histone → pulmonary + cutaneous
Distinct serologic–ESSDAI patterns may guide monitoring and management
@RheumNow #ACR25 A#2295
Jiha Lee JihaRheum ( View Tweet)
#ACR25 Abstr#LB14 Deep blood & tissue depletion are not just confined to CAR-T. Exploratory analysis of REGENCY showed Obinutuzumab induced near-complete depletion & significantly reduced plasma in kidney tissue vs PBO @RheumNow https://t.co/r1danWBM7D
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#ACR25 Abstr#LB01 After several smaller studies, a Multicentre, Phase 2b RCT of 152 #SLE pts in China. SRI-4 was met in IL-2 as s/c every other day for 12 wks, followed by weekly for another 12 wks vs PBO. Efficacy & T-regs expansion were dose dependent. On to Phase 3 @RheumNow https://t.co/L0rYr5D1R1
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Late Breaker: Phase 2 RCT of low dose IL2 in SLE
Dose dependent response in SRI4 over 12 weeks
& surprisingly high rates of LLDAS
Too early to know if useful, but worth evaluating in a phase 3
#ACR25 @RheumNow Abstr#LB01 https://t.co/oPOLG82nwi
Mike Putman EBRheum ( View Tweet)
Passive transfer of Ab can occur w #IVIg
#Ab can occur from IVIg passive transfer incl HepB
IVIg - if pt has #cryoglobulins
👇
Can precipitate severe #cryo flare
#ClinicalPearl
Secrets & Pearls session
#ACR25 @RheumNow @ACRheum https://t.co/tTaSuVy1yQ
Janet Pope Janetbirdope ( View Tweet)
#1726 IA from immune checkpoint inhibitors (ICI) is a distinct autoimmune entity: T cell-driven but not antibody-mediated
irAE arthritis shows hyperactive, cytotoxic CD8+ T cells & metabolic reprogramming, unlike RA. IL-6, IL-12 & IFNα fuel this process. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
