130 CHAPTER 6 Figure 4 | Phenotyping of BCRh clones in RA-risk individuals (A-C) CDR3 clonal overlap between peripheral blood (x-axis) and unsorted PBMCS (y-axis) is shown for three patients. (D-F) CDR3 clonal overlap between peripheral blood (x-axis) and sorted plasmablast/plasma cells (y-axis) is shown for three patients. (G-I) CDR3 clonal overlap between peripheral blood (x-axis) and sorted memory B cells (y-axis) is shown for three patients. Each dot represents a unique CDR3 BCR clone, and its frequency in the analyzed repertoire is depicted as percentage of total UMIs. The dotted lines on each axis indicate the 0.5% cut-off for dominant BCR clones. Discussion We combined two unique studies performed in RA-risk individuals, yielding novel data in the field of preclinical rheumatoid arthritis. At-risk individuals were randomized and treated with rituximab (RTX) or placebo in the PRAIRI study that demonstrated that RTX delayed the onset of RA [7]. Because the intervention was a single infusion with RTX, in contrast to the majority of clinical trials where RTX is dosed more than once, the course post-intervention can be studied more accurately. The current data demonstrates that the BCRh repertoire of RTX treated RA-risk individ-
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