{
  "abstract": "Objective To examine B cell-activating factor (BAFF) and type I interferon (IFN) activity at the transcriptional and protein levels in blood and placental tissue in SLE compared with healthy pregnancies to assess their relationship and to determine whether BAFF levels are associated with pregnancy outcomes in SLE.Methods In the SLE-Placenta study, we followed women with SLE (n=83) and healthy controls (n=67) throughout pregnancy. Blood samples were collected in all trimesters and at delivery from peripheral blood, placental intervillous blood and cord blood. Postpartum blood samples were obtained from a subset of women with SLE. Bulk messenger RNA (mRNA) sequencing was performed on peripheral blood mononuclear cells (PBMCs) and placental tissue from a subgroup of women with SLE and healthy controls. BAFF concentrations were measured by ELISA and IFNα protein levels by single-molecule array (Simoa).Results Women with SLE had upregulated BAFF ( TNFSF13B) and IFN-stimulated gene expression in PBMCs and placenta compared with controls. BAFF blood levels were consistently and significantly higher in SLE throughout pregnancy and inversely correlated with circulating B cell numbers. SLE pregnancies with IF-ANA or anti-dsDNA positivity displayed higher BAFF levels than antibody-negative pregnancies but BAFF showed no association with disease activity. Both BAFF and IFNα concentrations were higher in placental than peripheral blood in SLE, whereas only BAFF showed additional accumulation in cord blood. Finally, elevated BAFF levels were associated with shorter pregnancy duration in SLE but not in healthy pregnancy.Conclusions Pregnant women with SLE exhibited persistently elevated BAFF levels, which were associated with lower B cell numbers, SLE-related autoantibody positivity and shorter pregnancy duration. Together with a disease-specific placental enrichment of IFNα, these findings support the presence of an inflammatory and potentially pathogenic IFN-BAFF signature in SLE pregnancy. Further studies are needed to determine the functional consequences of these immunological alterations on maternal-fetal health in SLE.",
  "authors": [
    {
      "affiliations": [
        "Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Agnes Torell"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Kerstin Andersson"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Iva Gunnarsson"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Elisabet Svenungsson"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Agneta Zickert"
    },
    {
      "affiliations": [
        "Department of Women's and Children's Health, Division of Neonatology, Obstetrics, Gynaecology and Reproductive Health, Karolinska University Hospital, Stockholm, Sweden"
      ],
      "name": "Maria Majczuk Sennström"
    },
    {
      "affiliations": [
        "Rheumatology, Sahlgrenska University Hospital, Western Healthcare Region, Gothenburg, Sweden"
      ],
      "name": "Estelle Trysberg"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital Lund, Lund, Sweden"
      ],
      "name": "Anders A Bengtsson"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital Lund, Lund, Sweden"
      ],
      "name": "Andreas Jönsen"
    },
    {
      "affiliations": [
        "Department of Clinical Sciences Lund, Obstetrics and Gynecology, Skåne University Hospital Lund, Lund, Sweden"
      ],
      "name": "Helena Strevens"
    },
    {
      "affiliations": [
        "Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden"
      ],
      "name": "Christopher Sjöwall"
    },
    {
      "affiliations": [
        "Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden"
      ],
      "name": "Muna Saleh"
    },
    {
      "affiliations": [
        "Department of Biomedical and Clinical Sciences, Division of Children’s and Women’s Health, Linköping University, Linköping, Sweden"
      ],
      "name": "Sofia Pihl"
    },
    {
      "affiliations": [
        "Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Dag Leonard"
    },
    {
      "affiliations": [
        "Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Lars Ronnblom"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, Section of Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Tansim Akhter"
    },
    {
      "affiliations": [
        "Department of Life Sciences, National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Chalmers University of Technology, Gothenburg, Sweden"
      ],
      "name": "Fariba Roshanzamir"
    },
    {
      "affiliations": [
        "Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden",
        "Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK"
      ],
      "name": "Henrik Zetterberg"
    },
    {
      "affiliations": [
        "Department of Oral Microbiology and Immunology, Institute of Odontology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Johan Bylund"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Western Healthcare Region, Gothenburg, Sweden",
        "Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Bo Jacobsson"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Anna Rudin"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Anna-Carin Lundell"
    },
    {
      "affiliations": [
        "Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden",
        "Rheumatology, Sahlgrenska University Hospital, Western Healthcare Region, Gothenburg, Sweden"
      ],
      "name": "Marit Stockfelt"
    }
  ],
  "title": "Comparison of BAFF and type I IFN activity in blood and placenta in SLE and healthy pregnancies",
  "uid": "db9bd91c-07c0-53b1-b7bd-cc30ba98813b"
}