B cells

[maria garcia]

What are B cells? In a blood work panel where do I find it. Is there another Medical term? I keep hearing about it and I have no idea what it is or how it affects wegners. Can someone educate me?

[vdub]

I think this url might help. Go to the section "Lay Person Summary".
https://www.vasculitisfoundation.org/node/1888

[pberggren1]

The test for b cells is called CD19 and CD 20. Most docs do not test for them at all. Usually for Weggie the only time we are tested for these is when he have taken rtx infusions. And then a few months later the doc usually tests for them to see if they are returning or not.

B cells are the ones that form antibodies.

[Al]

What are B cells? In a blood work panel where do I find it. Is there another Medical term? I keep hearing about it and I have no idea what it is or how it affects wegners. Can someone educate me?

Maria, I commented on this subject in a different thread, but I know that navigating the forum can be challenging, particularly if the thread in question is more than a day old. So here goes:

B cells are a type of while blood cell, also called leukocytes. There are several different kinds of leukocytes: Neutrophils, Eosinophils, Basophils (these three are also called granulocytes, as they carry bits of protein used for a variety of immune system functions), Monocytes, and two forms of Lymphocytes: B cells and T cells, both of which are important players in Wegener’s and similar diseases. You won’t see anything labeled “B cells” in a normal blood panel, But you might see a breakdown of the various while blood cell components, including a line called “lymphocytes”, or “LY”, measured in both absolute numbers and as a percentage of total leukocytes. A differentiation of B cells from the various kinds of T cells takes more specialized tests, These are sometimes asked for, but rarely, unless there is a specific need. In the case of B cells, the measurement is an aid in telling how Rituxan treatment is progressing.

The relationship among all these players (and this is just the start of the full cast!) and Wegener’s is exceedingly complex. But to make it simple, B cells produce the antibodies to certain antigens that the immune system believes to be bad news. In autoimmune diseases, this “belief” turns out to be a mistake, at least in part. Of the many types of antibodies produced by the B cells, the kinds most involved with Wegener’s are called ANCA (Anti-Neutrophil Cytoplasmic Autoantibodies). ANCA themselves come in at least two main forms: those that attack myeloperoxidase (MPO), and those that go after proteinase 3 (PR-3). Under the microscope, A P-ANCA presentation is associated with anti-MPO; a C-ANCA presentation with anti-PR-3.

How the body becomes damaged from all this antibody activity is a long and fascinating story itself. But without opening that can of worms right now, the first item of business for any treatment plan is to clear out the rogue antibodies as much as possible, which is where prednisone (or prednisolone, the IV form) and plasma exchange come into the picture. The next goal is to prevent, or at least tame down, the production of new antibodies. This is what cytoxan and rituxan are supposed to accomplish. CTX bashes down the entire immune system; RTX targets just the B cells.

There are pluses and minuses to each approach. Neither is, in fact, ideal. Better yet would be to re-train the B cells to stop manufacturing ANCA. No one knows how to do this. Another line of therapy might be to intercept the ANCA before they can cause harm. There are, in fact, a couple of ideas on how to do this, though they are a long way from being part of the standard treatment program. We live in interesting times.

I hope this helps!

Al

[maria garcia]

Thank you for the information. I need to be up to date wilth all of this.

[watersedge]

Always wondered about this too, never really understood it much but that was a great explanation Al, once you read it through once or twice you start to understand it.

[kulharv]

Al,

Thanks for the info. I have just finished my RTX treatment and was told that it would just be the B cells that they test for. After reading your thread, I now know what I should be looking for when looking at my blood reports.

Once again THANKS!

Harvi

[Al]

Thanks for the info. I have just finished my RTX treatment and was told that it would just be the B cells that they test for. After reading your thread, I now know what I should be looking for when looking at my blood reports.

Blood reports are informative, Harvi, but they need to be taken in the context of everything else, including how you feel. And that must be taken in the context of your history--exactly what many modern doctors are skittish about! Pneumonia doesn't help here; we hope this part is ancient history for you!

Al

[pberggren1]

It is the Z cells we have to worry about the most.

[drz]

I think this info would be good to add to the thread on what new people need to know!


Maria, I commented on this subject in a different thread, but I know that navigating the forum can be challenging, particularly if the thread in question is more than a day old. So here goes:

B cells are a type of while blood cell, also called leukocytes. There are several different kinds of leukocytes: Neutrophils, Eosinophils, Basophils (these three are also called granulocytes, as they carry bits of protein used for a variety of immune system functions), Monocytes, and two forms of Lymphocytes: B cells and T cells, both of which are important players in Wegener’s and similar diseases. You won’t see anything labeled “B cells” in a normal blood panel, But you might see a breakdown of the various while blood cell components, including a line called “lymphocytes”, or “LY”, measured in both absolute numbers and as a percentage of total leukocytes. A differentiation of B cells from the various kinds of T cells takes more specialized tests, These are sometimes asked for, but rarely, unless there is a specific need. In the case of B cells, the measurement is an aid in telling how Rituxan treatment is progressing.

The relationship among all these players (and this is just the start of the full cast!) and Wegener’s is exceedingly complex. But to make it simple, B cells produce the antibodies to certain antigens that the immune system believes to be bad news. In autoimmune diseases, this “belief” turns out to be a mistake, at least in part. Of the many types of antibodies produced by the B cells, the kinds most involved with Wegener’s are called ANCA (Anti-Neutrophil Cytotoxic Antibodies. ANCA themselves come in at least two main forms: those that attack myeloperoxidase (MPO), and those that go after proteinase 3 (PR-3). Under the microscope, A P-ANCA presentation is associated with anti-MPO; a C-ANCA presentation with anti-CP-3.

How the body becomes damaged from all this antibody activity is a long and fascinating story itself. But without opening that can of worms right now, the first item of business for any treatment plan is to clear out the rogue antibodies as much as possible, which is where prednisone (or prednisolone, the IV form) and plasma exchange come into the picture. The next goal is to prevent, or at least tame down, the production of new antibodies. This is what cytoxan and rituxan are supposed to accomplish. CTX bashes down the entire immune system; RTX targets just the B cells.

There are pluses and minuses to each approach. Neither is, in fact, ideal. Better yet would be to re-train the B cells to stop manufacturing ANCA. No one knows how to do this. Another line of therapy might be to intercept the ANCA before they can cause harm. There are, in fact, a couple of ideas on how to do this, though they are a long way from being part of the standard treatment program. We live in interesting times.

I hope this helps!

Al

[Al]

If we do this, I'll correct a couple of typos! (My daughter is the editor; I just slog through things and fix them later....)

Al

[maria garcia]

Al your full of wisdom.

[Al]

Al your full of wisdom.

Maria--my family would agree with you up to the last word. Short story out of family lore: When my daughter was 3 or 4, she caught me in some error--I can't remember whether it was an error in grammar, spelling, or something factual. Anyway, when I humbled myself and apologized, she said, "Well Dad, I am a little ahead of you when it comes to smartness." (The continuation of this story: a couple of years later, I pointed out to her that "old age and treachery will beat youth and intelligence any day." She stared me in the eye and said, "Youth, intelligence and treachery will beat plain old age...every day!")

Al