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¹ Laboratory of Molecular Immunology, The Rockefeller University, New York, NY 10021
² Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
³ Max-Planck Institute for Infection Biology, D-10117 Berlin, Germany
⁴ Baylor Institute for Immunology Research, Dallas, TX 75204
⁵ Howard Hughes Medical Institute New York, NY 10021

CORRESPONDENCE Hedda Wardemann: wardemann{at}mpiib-berlin.mpg.de OR Michel C. Nussenzweig: nussen{at}mail.rockefeller.edu

A majority of the antibodies expressed by nascent B cells in healthy humans are self-reactive, but most of these antibodies are removed from the repertoire during B cell development. In contrast, untreated systemic lupus erythematosus (SLE) patients fail to remove many of the self-reactive and polyreactive antibodies from the naive repertoire. Here, we report that SLE patients in clinical remission continue to produce elevated numbers of self-reactive and polyreactive antibodies in the mature naive B cell compartment, but the number of B cells expressing these antibodies is lower than in patients with active disease. Our finding that abnormal levels of self-reactive mature naive B cells persist in the majority of patients in clinical remission suggests that early checkpoint abnormalities are an integral feature of SLE.

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