How to tell if an Autoimmune process is driven by B cells or T cells?

[crypt0cu1t]

Hey everyone, as you all know I have tons of issues with autoimmunity (LEMS, Autoimmune encephalitis, Sjogrens).

From the research I have been doing, it seems B cell mediated autoimmunity has a better outlook treatment wise vs T cell. So, how can i tell if mine is mediated by T or B cells?

I'll tag @Gingergrrl @Learner1 @SK2018 @Jesse2233 since you guys seem to know alot about these things!

 

[Gingergrrl]

From the research I have been doing, it seems B cell mediated autoimmunity has a better outlook treatment wise vs T cell. So, how can i tell if mine is mediated by T or B cells?

I have no idea! I thought autoimmunity was B-cell driven in general but don't know anything more than that. Am hoping someone else knows more than me.

 

[Learner1]

Not sure. I've been told Hashimotos is T cell and some of the EBV driven ones are B cell. I'd look to Dr. Chedda for more info.

 

[Gingergrrl]

I've been told Hashimotos is T cell and some of the EBV driven ones are B cell.

Thanks and that is interesting. I have Hashimoto's and did not know it was T-cell driven.

 

[Learner1]

And you still have it after you had Ritiximab, which goes after your B cells, yes? Or did the Ritux make it go away?

 

[Gingergrrl]

And you still have it after you had Ritiximab, which goes after your B cells, yes? Or did the Ritux make it go away?

No, I still have Hashimoto's and the Rituximab did not make it go away. I do not have any active symptoms from it (that I am aware of) but I also take Armour Thyroid every morning which helps keep my thyroid numbers in the correct range. I still have the two Hashi's autoantibodies and per my Endo, I always will.

I have an appt w/him on Fri and will post an update after the appt in the thread re: my Endo stuff. My bigger issue is tapering off Cortef and seeing where my bloodwork is now that I've done the first step of the taper (from 15 mg per day to 13.75 mg per day) which took me about 8-9 wks but I did it. If my numbers are okay, I will start the next phase of tapering down to 12.5 mg per day.

But to get back on topic, I actually have no idea which autoantibodies are B-cell vs. T-cell and somehow assumed they were all B-cell (but what you said re: Hashi's makes sense)!

 

[Learner1]

Two immunologist at the University of Washington told me that Hashis was T cell driven. A paper I found says "It is an organ-specific T-cell mediated disease that affects the thyroid, and genetics play a contributory role in its complexity."

So, while it'd be nice to get rid of, Ritux won't do it.

 

[Zebra]

Hi, there!

I have had some B cell and T cell subset testing done.

I recently had this test run: https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9336

The results provided a nice overview on your B cell, T cell, and NK cells. The results show several subsets of each kind of lymphocyte.

I also have issues with autoimmunity, which in my case, has lowered by B cell count.

To this end, I have had this test run: https://www.mayomedicallaboratories.com/test-catalog/Overview/88800

This test really goes into the nitty-gritty of more B cell subsets than I knew existed.

Sadly, none of this information has furthered my care in any way, except that I now know not to take any medications that destroy B cells.

Hope this is the kind of information you were looking for!

Z

 

[Gingergrrl]

So, while it'd be nice to get rid of, Ritux won't do it.

I agree and for whatever reason, even though Hashi's is autoimmune, it never even crossed my mind that Rituximab could help or change it (vs. for LEMS, Autoimmune POTS, and some of my other problems). Maybe this is b/c I knew it was different, but I did not know why or how, and now I know it is T-cells vs. B-cells.

I also have issues with autoimmunity, which in my case, has lowered by B cell count.

Sadly, none of this information has furthered my care in any way, except that I now know not to take any medications that destroy B cells.

That is interesting @Zebra and in my case, I was told that destroying the B-cells was my best chance at helping my autoimmune issues (and it turned out to be correct). Do you know why you were told that you should not take meds that destroy B-cells since you have issues with autoimmunity? As much as I have tried to study all of this, I still have a very rudimentary understanding! My B-cells are at zero with Rituximab (which is the goal) but I did not test them prior to starting so am not sure where they were then.

 

[SK2018]

FACS ASSAY

flow cytometry test for Lymphocyte subsets ,remember a B cell can't make an antibody without a T cell allowing it to do so and in many cases "instructing it" to do so ,usually both are involved.

Hey everyone, as you all know I have tons of issues with autoimmunity (LEMS, Autoimmune encephalitis, Sjogrens).

From the research I have been doing, it seems B cell mediated autoimmunity has a better outlook treatment wise vs T cell. So, how can i tell if mine is mediated by T or B cells?

I'll tag @Gingergrrl @Learner1 @SK2018 @Jesse2233 since you guys seem to know alot about these things!

Hey everyone, as you all know I have tons of issues with autoimmunity (LEMS, Autoimmune encephalitis, Sjogrens).

From the research I have been doing, it seems B cell mediated autoimmunity has a better outlook treatment wise vs T cell. So, how can i tell if mine is mediated by T or B cells?

I'll tag @Gingergrrl @Learner1 @SK2018 @Jesse2233 since you guys seem to know alot about these things!

 

[Jesse2233]

Trialing treatments...

Prednisone, if you get better it's likely immune mediated

Plasmapheresis, if you get better it's likely B-cell

Photopheresis, if you get better it's likely T-cell

 

[SK2018]

Trialing treatments...

Prednisone, if you get better it's likely immune mediated

Plasmapheresis, if you get better it's likely B-cell

Photopheresis, if you get better it's likely T-cell

Yes ,

And better from

ATG
Ale-mtuzu-mab
Or cyclophosphamide

Likely T cell mediated also.

 

[Gingergrrl]

Trialing treatments...

Prednisone, if you get better it's likely immune mediated
Plasmapheresis, if you get better it's likely B-cell
Photopheresis, if you get better it's likely T-cell

That is an interesting way to look at it. Could you also assume that if someone improved from high dose IVIG and Rituximab that it was therefore also B-cell? (I would assume yes but wanted to add it to your list).

 

[ebethc]

Two immunologist at the University of Washington told me that Hashis was T cell driven. A paper I found says "It is an organ-specific T-cell mediated disease that affects the thyroid, and genetics play a contributory role in its complexity."

So, while it'd be nice to get rid of, Ritux won't do it.

is there a strong relationship between thymus and thyroid?

 

[Gingergrrl]

is there a strong relationship between thymus and thyroid?

My Endo who monitors my thyroid has never mentioned anything re: thymus, so I assume there is not a strong relationship, but I really don't know what I am talking about

 

[ebethc]

My Endo who monitors my thyroid has never mentioned anything re: thymus, so I assume there is not a strong relationship, but I really don't know what I am talking about

I just bought some standard process thymex and many reviews mentioned thyroid... I think they're confused

 

[Jesse2233]

That is an interesting way to look at it. Could you also assume that if someone improved from high dose IVIG and Rituximab that it was therefore also B-cell? (I would assume yes but wanted to add it to your list).

I would think so with the caveat being there’s a lot about these treatments we don’t understand.