Dysregulated B cell function and disease pathogenesis in systemic sclerosis.

A double blind randomised control trial of belimumab vs placebo with background MMF including 20 SSc patients failed to reach statistical significance but demonstrated greater improvement in mRSS with belimumab compared with MMF alone ( 161 ).

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This may be significant as ligation of CD180 induces affinity maturation and programs immature (including T1) and mature B cell subsets to become efficient antigen presenting cells to T follicular helper cells ( 81 , 82 ).

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