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P-glycoprotein Expressing-B cell associated Active True Renal Lupus Vasculitis in Lupus Nephritis

Shizuyo Tsujimura, Akio Kawabe, Yoshiya Tanaka*

True renal lupus vasculitis (TRLV), a rare form of vascular lesion usually associated with proliferative lupus nephritis 
(LN), is resistant to conventional treatments and associated with poor renal outcome among renal vasculopathies. 
Evidence suggests the involvement of P-glycoprotein (P-gp) expressing-activated B cells in the pathogenesis and 
treatment resistance of TRLV through the production of autoantibodies and direct infiltration into the inflammatory 
lesion of small vessels. Therapies targeting activated B cells might overcome refractory TRLV. Identification of 
the subsets of peripheral activated B cells that express P-gp in TRLV patients might help the selection of suitable 
treatment strategy.