B cell test interpretation

[Learner1]

Yes, you coukd have a "B cell panel" run.

 

[Gingergrrl]

Yes, you coukd have a "B cell panel" run.

Would the results be of clinical value or guide treatment?

 

[Lalia]

In a normal person, at any given point in time, are they supposed to have the majority of their B cells be "mature" and only a small percentage be "naive"? Also, are there tests which show the different types of B cells that someone has? In my case, I have zero from Rituximab (for now) but I was just wondering if this can even be tested?

Sorry for the slow reply - I think the answer to your question is yes, at least according to this paper:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719933/

It states that "CFS patients had greater numbers of naive B cells as a percentage of lymphocytes: 6·3 versus 3·9% in healthy controls (P = 0·034) and greater numbers of naive B cells as a percentage of B cells: 65 versus 47% in controls." So it would make sense that healthy people have more mature B cells than people with CFS (although I don't know if healthy people have a majority of B cells, it seems like they have more of a 50/50 split in the above study.

I am asking for more detailed B cell testing, and in terms of clinical value I think it would simply get me one step closer to understanding what my B cells are doing and where there may be a disconnect. From what I've read, there are a whole bunch of genes and proteins involved in B cell development. So if I knew more about my B cells, it may direct me to further research on what's going wrong. I found this paper on B cell deficiency and severe autoimmunity interesting for my own case. The patient had a gene mutation in protein C kinase which severely affected his immune system and ability to make B cells: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630826/

This is just my interpretation of the studies tho - as always I may be completely off-track and often feel like I'm muddling through this research

 

[Gingergrrl]

I am asking for more detailed B cell testing, and in terms of clinical value I think it would simply get me one step closer to understanding what my B cells are doing and where there may be a disconnect. From what I've read, there are a whole bunch of genes and proteins involved in B cell development. So if I knew more about my B cells, it may direct me to further research on what's going wrong.

I am so fascinated by your case @Lalia and thank you for sharing it with me and with all of us. I plan to reply to your most recent PM's as soon as I can. I am glad that you are asking for more detailed B-cell testing, and I know it is not easy to get all of this stuff in Australia, and you sound like a great advocate. I can't do any B-cell testing since my B-cells are at zero from Rituximab. I am still not sure what it would change clinically (in my case?) but it sounds like it would give you more knowledge re: genetics of B-cell development and direct you to further research re: your case?

I found this paper on B cell deficiency and severe autoimmunity interesting for my own case.

I apologize that I have not had a chance to read any of the papers that you linked but I am keeping everything for future reference. I know you have already explained this to me and I often struggle to retain scientific info. I think I understand now though (please correct me if I am wrong!) that HIGH B-cell counts correlate with autoimmunity but in your case you have a B-cell deficiency and severe autoimmunity. I agree that is strange and wish I knew more!

This is just my interpretation of the studies tho - as always I may be completely off-track and often feel like I'm muddling through this research

You understand all of these studies much better than I do and I don't think you are off-track at all.

 

[Lalia]

I am so fascinated by your case @Lalia and thank you for sharing it with me and with all of us. I plan to reply to your most recent PM's as soon as I can. I am glad that you are asking for more detailed B-cell testing, and I know it is not easy to get all of this stuff in Australia, and you sound like a great advocate. I can't do any B-cell testing since my B-cells are at zero from Rituximab. I am still not sure what it would change clinically (in my case?) but it sounds like it would give you more knowledge re: genetics of B-cell development and direct you to further research re: your case?

Thank you muchly for the encouragement @Gingergrrl ! Sometimes it feels like trying to move mountains. Yes, I hope further testing would shed more light. Just out of interest, did your doctor ever investigate primary immunodeficiency as the root cause of your problems? Or was it ruled out because your IgG was normal? Also, apols, I had asked about your IgG in my PM but missed your earlier reply on this thread where you said it was normal.

 

[Lalia]

I apologize that I have not had a chance to read any of the papers that you linked but I am keeping everything for future reference. I know you have already explained this to me and I often struggle to retain scientific info. I think I understand now though (please correct me if I am wrong!) that HIGH B-cell counts correlate with autoimmunity but in your case you have a B-cell deficiency and severe autoimmunity. I agree that is strange and wish I knew more!

I think they usually do, because B cells produce antibodies. But I’ve since seen some references to T cells driving AI, so I think there can be several factors that drive AI and B cells are only one of them! So much to learn

 

[Gingergrrl]

Thank you muchly for the encouragement @Gingergrrl ! Sometimes it feels like trying to move mountains.

No problem and I agree!

Just out of interest, did your doctor ever investigate primary immunodeficiency as the root cause of your problems? Or was it ruled out because your IgG was normal? Also, apols, I had asked about your IgG in my PM but missed your earlier reply on this thread where you said it was normal.

I am behind on PM's (or might have missed that question)! I don't believe that immunodeficiency was considered in my case b/c I did not have low IgG. There was one test in which I was low in IgG Subclass 3 but other than that, it was in the normal range. And now my IgG levels are above the ranges but this is considered normal after almost 2 years of IVIG.

My NK cell functioning was very low but I later learned that this can correlate to many things (CIRS- mold illness, MCAS, etc, and is not a bio-marker for anything as far as I understand). But in general, by early 2016, my system was so far skewed toward autoimmunity (positive ANA, Hashimoto's Disease, 11 autoantibodies, constant anaphylaxis/allergic reactions, etc-- at that time) that both of my doctors felt we needed to address the autoimmunity.

So much to learn

I agree, it is endless, and when you figure it out, you can teach me (for real... I am not being sarcastic )! I feel like I still know nothing.