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

Discussion in 'General Treatment' started by crypt0cu1t, Aug 5, 2018.

  1. crypt0cu1t

    crypt0cu1t IG: @skagginwagon

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    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!
     
  2. Gingergrrl

    Gingergrrl Senior Member

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    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.
     
  3. Learner1

    Learner1 Forum Support Assistant

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    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.
     
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  4. Gingergrrl

    Gingergrrl Senior Member

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    Thanks and that is interesting. I have Hashimoto's and did not know it was T-cell driven.
     
  5. Learner1

    Learner1 Forum Support Assistant

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

    Gingergrrl Senior Member

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    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)!
     
  7. Learner1

    Learner1 Forum Support Assistant

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    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.
     
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  8. Zebra

    Zebra

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    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
     
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  9. Gingergrrl

    Gingergrrl Senior Member

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    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.

    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.
     
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  10. SK2018

    SK2018 SK

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    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.

     
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  11. Jesse2233

    Jesse2233 Senior Member

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    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
     
  12. SK2018

    SK2018 SK

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    Yes ,

    And better from

    ATG
    Ale-mtuzu-mab
    Or cyclophosphamide

    Likely T cell mediated also.
     
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  13. Gingergrrl

    Gingergrrl Senior Member

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    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).
     
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  14. ebethc

    ebethc Senior Member

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    is there a strong relationship between thymus and thyroid?
     
  15. Gingergrrl

    Gingergrrl Senior Member

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    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 ;)
     
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  16. ebethc

    ebethc Senior Member

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    :)

    I just bought some standard process thymex and many reviews mentioned thyroid... I think they're confused :)
     
  17. Jesse2233

    Jesse2233 Senior Member

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