Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19.

Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19.
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流体外B细胞反应与COVID-19的中和抗体和发病率相关。

DOI:
10.1038/s41590-020-00814-z
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发表时间:
2020-12
期刊:
影响因子:
30.5
通讯作者:
Sanz I
Sanz I
中科院分区:
医学1区
文献类型:
--
作者:
Woodruff MC;Ramonell RP;Nguyen DC;Cashman KS;Saini AS;Haddad NS;Ley AM;Kyu S;Howell JC;Ozturk T;Lee S;Suryadevara N;Case JB;Bugrovsky R;Chen W;Estrada J;Morrison-Porter A;Derrico A;Anam FA;Sharma M;Wu HM;Le SN;Jenks SA;Tipton CM;Staitieh B;Daiss JL;Ghosn E;Diamond MS;Carnahan RH;Crowe JE Jr;Hu WT;Lee FE;Sanz I

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A wide spectrum of clinical manifestations has become a hallmark of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) COVID-19 pandemic, although the immunological underpinnings of diverse disease outcomes remain to be defined. We performed detailed characterization of B cell responses through high-dimensional flow cytometry to reveal substantial heterogeneity in both effector and immature populations. More notably, critically ill patients displayed hallmarks of extrafollicular B cell activation and shared B cell repertoire features previously described in autoimmune settings. Extrafollicular activation correlated strongly with large antibody-secreting cell expansion and early production of high concentrations of SARS-CoV-2-specific neutralizing antibodies. Yet, these patients had severe disease with elevated inflammatory biomarkers, multiorgan failure and death. Overall, these findings strongly suggest a pathogenic role for immune activation in subsets of patients with COVID-19. Our study provides further evidence that targeted immunomodulatory therapy may be beneficial in specific patient subpopulations and can be informed by careful immune profiling.
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