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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Nat+Immunol 2020 ; 21 (12): 1506-1516 Nephropedia Template TP
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Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19 #MMPMID33028979
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
Nat Immunol 2020[Dec]; 21 (12): 1506-1516 PMID33028979show ga
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.