CD19⁺CD24^hiCD38^hi regulatory B cells exert immunosuppressive functions by producing IL-10, but their role in idiopathic membranous nephropathy (IMN) remains elusive. Here, we investigated the frequency and functional changes of circulating CD19⁺CD24^hiCD38^hi B cells and evaluated the correlation of CD19⁺CD24^hiCD38^hi B cells with clinical features and T helper cell subsets in IMN patients. Compared with healthy controls (HCs), IMN patients showed an increased frequency of CD19⁺CD24^hiCD38^hi B cells, but a significant reduction in the percentage of CD19⁺CD24^hiCD38^hi B cells was observed 4 weeks after cyclophosphamide treatment. The frequency of CD19⁺CD24^hiCD38^hi B cells was positively correlated with the levels of 24h urinary protein, but negatively correlated with serum total protein and serum albumin, respectively. CD19⁺CD24^hiCD38^hi B cells in IMN patients displayed a skewed pro-inflammatory cytokine profile with a higher level of IL-6 and IL-12, but a lower concentration of IL-10 than their healthy counterparts. Accompanied by upregulation of Th2 and Th17 cells in IMN patients, the percentage of CD19⁺CD24^hiCD38^hi B cell subset was positively associated with Th17 cell frequency. In conclusion, CD19⁺CD24^hiCD38^hi B cells were expanded but functionally impaired in IMN patients. Their altered pro-inflammatory cytokine profile may contribute to the pathogenesis of IMN.

CD19 ⁺ CD24 ^hi CD38 ^hi调节性 B 细胞通过产生 IL-10 发挥免疫抑制功能，但它们在特发性膜性肾病 (IMN) 中的作用仍然难以捉摸。^{在这里，我们研究了循环 CD19 +} CD24 ^hi CD38 ^hi B 细胞的频率和功能变化，并评估了IMN 患者中CD19 ⁺ CD24 ^hi CD38 ^{hi B 细胞与临床特征和 T 辅助细胞亚群的相关性。与健康对照（HC）相比，IMN患者的CD19 +} CD24 ^hi CD38 ^hi B细胞频率增加，但环磷酰胺治疗4周后观察到CD19 ⁺ CD24 ^hi CD38 ^hi B细胞百分比显着降低。^{CD19 +} CD24hiCD38hiB细胞频率与24h尿蛋白水平呈正相关，与血清总蛋白、血清白蛋白呈^负相关^。IMN 患者中的CD19 ⁺ CD24 ^hi CD38 ^hi B 细胞表现出倾斜的促炎细胞因子谱，与健康患者相比，IL-6 和 IL-12 水平较高，但 IL-10 浓度较低。^{伴随IMN患者Th2和Th17细胞的上调，CD19 +} CD24 ^hi CD38 ^hi B细胞亚群的百分比与Th17细胞频率呈正相关。总之，IMN 患者中 CD19 ⁺ CD24 ^hi CD38 ^hi B 细胞扩增，但功能受损。它们改变的促炎细胞因子谱可能有助于 IMN 的发病机制。