Identification of B cell defects using age-defined reference ranges for in vivo and in vitro B cell differentiation

J Immunol. 2013 May 15;190(10):5012-9. doi: 10.4049/jimmunol.1201807. Epub 2013 Apr 12.

Abstract

Primary immunodeficiencies consist to a large extent of B cell defects, as indicated by inadequate Ab levels or response upon immunization. Many B cell defects have not yet been well characterized. Our objective was to create reliable in vivo and in vitro assays to routinely analyze human B cell differentiation, proliferation, and Ig production and to define reference ranges for different age categories. The in vitro assays were applied to classify the developmental and/or functional B cell defects in patients previously diagnosed with common variable immunodeficiency. Apart from standard immunophenotyping of circulating human B cell subsets, an in vitro CFSE dilution assay was used for the assessment of proliferative capacity comparing T cell-dependent and T cell-independent B cell activation. Plasmablast/plasma cell differentiation was assessed by staining for CD20, CD38, and CD138, and measurement of in vitro Ig secretion. At young age, B cells proliferate upon in vitro activation, but neither differentiate nor produce IgG. These latter functions reached adult levels at 5 and 10 y of age for T cell-dependent versus T cell-independent stimulations, respectively. The capacity of B cells to differentiate into plasmablasts and to produce IgG appeared to be contained within the switched memory B cell pool. Using these assays, we could categorize common variable immunodeficiency patients into subgroups and identified a class-switch recombination defect caused by an UNG mutation in one of the patients. We defined age-related reference ranges for human B cell differentiation. Our findings indicate that in vivo B cell functionality can be tested in vitro and helps to diagnose suspected B cell defects.

MeSH terms

  • ADP-ribosyl Cyclase 1 / analysis
  • Adult
  • Antibodies / blood
  • Antigens, CD20 / analysis
  • B-Lymphocyte Subsets / classification
  • B-Lymphocyte Subsets / cytology
  • B-Lymphocyte Subsets / immunology*
  • B-Lymphocytes / classification
  • B-Lymphocytes / cytology
  • B-Lymphocytes / immunology*
  • Cell Differentiation / immunology
  • Cell Proliferation
  • Cells, Cultured
  • Common Variable Immunodeficiency / classification
  • Common Variable Immunodeficiency / immunology*
  • Female
  • Humans
  • Immunoglobulins / biosynthesis
  • Immunophenotyping
  • Lymphocyte Activation / immunology*
  • Male
  • Reference Values
  • Syndecan-1 / analysis
  • T-Lymphocytes / immunology*

Substances

  • Antibodies
  • Antigens, CD20
  • Immunoglobulins
  • Syndecan-1
  • ADP-ribosyl Cyclase 1