ArticleSichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition2026
[Characterization of Immune Reconstitution Patterns in B-cell Subsets Mediated by B-cell Targeted Therapies].
Article in Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To analyze the reconstitution patterns of fine B-cell subsets in patients following treatment with the CD20 monoclonal antibody ofatumumab and the CD19 monoclonal antibody inebilizumab, and to evaluate the clinical application value of individualized fine B-cell subset dynamic profiling in guiding targeted therapy strategies. Methods: This prospective study enrolled 30 patients with pemphigus receiving ofatumumab and 26 patients with neuromyelitis optica spectrum disorders (NMOSD) receiving inebilizumab at West China Hospital of Sichuan University between October 2023 and May 2025. Thirty healthy individuals were enrolled as controls for baseline comparison. Dynamic monitoring of fine B-cell subsets, anti-desmoglein (Dsg) antibodies, and immunoglobulins was performed at three post-treatment time points (1 month, 3 months, and 6 months). A natural cubic spline model was used to fit trend curves, combined with differential analysis to assess population-level immune reconstitution. Results: At baseline (T0), patients in the pemphigus group had higher levels of several B-cell subsets compared to healthy controls. Total B-cell counts were 347.50 (250.40-621.8) cells/μL versus 217.50 (143.50-275.30) cells/μL, memory B-cell counts were 127.30 (74.63-196.70) cells/μL versus 57.00 (41.75-88.25) cells/μL, and plasmablast counts were 5.63 (2.02-11.48) cells/μL versus 1.00 (1.00-2.00) cells/μL. These differences were significant ( Conclusion: Targeted therapies against CD19 and CD20 induce distinctly different patterns of B-cell reconstitution. Ofatumumab treatment leads to a phased regenerative process in B cells, whereas inebilizumab treatment results in delayed regeneration. Increased plasmablasts, aberrant memory B-cell proliferation, and rebounding Dsg antibodies may signal potential adverse events. These findings support monitoring fine B-cell subsets for precise immunological assessment to guide personalized treatment.
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