Unknown,Transcriptomics,Genomics,Proteomics

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ScRNA-seq of PBMCs from stable ITP patients before TPO-RA discontinuation. STOPAGO study.

ABSTRACT: The STOPAGO study enrolled adults with persistent or chronic primary immune thrombocytopenia (ITP) and complete response to thrombopoietin receptor agonist (TPO-RA). TPO-RA discontinuation was planned in the study and patients with sustained complete response off-treatment (SCROT, platelet count > 100 G/L and no bleeding) and non sustained response (NSR, platelet count < 30 G/L or bleeding) were identified at week 24. RNAseq of peripheral blood mononuclear cells was performed at baseline, before TPO-RA discontinuation. Samples originated from 8 patients (4 with SCROT and 4 with NSR). The objectif was to identify putative markers that would predict relapses after TPO-RA discontinuation by comparing SCROT and NSR patients.

INSTRUMENT(S): Illumina NovaSeq 6000

ORGANISM(S): Homo sapiens

SUBMITTER: Etienne Crickx

PROVIDER: E-MTAB-12397 | biostudies-arrayexpress |

REPOSITORIES: biostudies-arrayexpress

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Project description:Rituximab (RTX) is widely used as a first-line therapeutic strategy in B cell-mediated autoimmune diseases. However, a large proportion of patients either do not respond to the treatment or relapse during B cell reconstitution. Primary immune thrombocytopenia (ITP) is a prototypic B cell mediated autoimmune disease in which pathogenic antibodies directed against the platelet membrane glycoprotein IIb-IIIa (GPIIbIIIa) lead to platelet destruction by macrophages in the spleen. In ITP, RTX-mediated B-cell depletion leads to an immediate clinical response in 50% of patients but 80% of patients will subsequently relapse in the next following months. Patients failing to respond or relapsing after RTX treatment are splenectomized when alternative therapies are inefficient or unavailable. Therapeutic splenectomy, resulting in a durable platelet response in 60-70 % of ITP patients, offers a unique access to study the autoimmune response in the spleen. To understand the cellular basis of disease's relapse in secondary lymphoid organs in humans, memory B cells were sorted and analyzed by scRNAseq from the spleen of three different groups of splenectomized ITP patients: 1) Patients that achieved a complete response after a course of RTX and relapsed during B-cell reconstitution (hereafter referred to as “RTX relapse” patients), 2) patients with primary failure of RTX, i.e. who did not respond to treatment at the time of B-cell depletion (“RTX failure” patients), 3) patients with active ITP that were not treated with RTX (“ITP” patients). All were compared with sorted splenic memory B cells from organ donors with no immune disease who died from stroke or head trauma, hereafter referred to as healthy donors (“HD” patients). We also included in this analysis splenic memory B cells from children with sickle cell disease that underwent splenectomy and are known to have a high frequency of B cell activation secondary to classical childhood infections and vaccinations, reflected by an increased number of GC. Single-cell mRNA sequencing was performed according to an adapted version of the SORT-seq protocol (Muraro et al., 2016, Cell Systems 3, 385–394), with cDNA libraries generation, sequencing and reads alignment performed at Single Cell Discoveries (Utrecht, Netherlands).

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ScRNA-seq of PBMCs from stable ITP patients before TPO-RA discontinuation. STOPAGO study.

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