Generation of a single-cell B cell atlas of antibody repertoires and transcriptomes to identify signatures associated with antigen specificity.

Although new genomics-based pipelines have potential to augment antibody discovery, these methods remain in their infancy due to an incomplete understanding of the selection process that governs B cell clonal selection, expansion, and antigen specificity. Furthermore, it remains unknown how factors such as aging and reduction of tolerance influence B cell selection. Here we perform single-cell sequencing of antibody repertoires and transcriptomes of murine B cells following immunizations with a model therapeutic antigen target. We determine the relationship between antibody repertoires, gene expression signatures, and antigen specificity across 100,000 B cells. Recombinant expression and characterization of 227 monoclonal antibodies revealed the existence of clonally expanded and class-switched antigen-specific B cells that were more frequent in young mice. Although integrating multiple repertoire features such as germline gene usage and transcriptional signatures failed to distinguish antigen-specific from nonspecific B cells, other features such as immunoglobulin G (IgG) subtype and sequence composition correlated with antigen specificity.

Phenotypic determinism and stochasticity in antibody repertoires of clonally expanded plasma cells.

The capacity of humoral B cell-mediated immunity to effectively respond to and protect against pathogenic infections is largely driven by the presence of a diverse repertoire of polyclonal antibodies in the serum, which are produced by plasma cells (PCs). Recent studies have started to reveal the balance between deterministic mechanisms and stochasticity of antibody repertoires on a genotypic level (i.e., clonal diversity, somatic hypermutation, and germline gene usage). However, it remains unclear if clonal selection and expansion of PCs follow any deterministic rules or are stochastic with regards to phenotypic antibody properties (i.e., antigen-binding, affinity, and epitope specificity). Here, we report on the in-depth genotypic and phenotypic characterization of clonally expanded PC antibody repertoires following protein immunization. We find that clonal expansion drives antigen specificity of the most expanded clones (top ∼10), whereas among the rest of the clonal repertoire antigen specificity is stochastic. Furthermore, we report both on a polyclonal repertoire and clonal lineage level that antibody-antigen binding affinity does not correlate with clonal expansion or somatic hypermutation. Last, we provide evidence for convergence toward targeting dominant epitopes despite clonal sequence diversity among the most expanded clones. Our results highlight the extent to which clonal expansion can be ascribed to antigen binding, affinity, and epitope specificity, and they have implications for the assessment of effective vaccines.

'No more routine outpatient appointments in the NHS': it is time to shift to data-driven appointment.

Currently, outpatient care in the UK is expensive and needs improvement, with traditional systems having been identified as no longer fit for purpose. Making sustainable changes to outpatient appointment systems is vital in order to meet increasing demands and cost. Shifting to data and technology-driven outpatient care may be one way to tackle these demands. As technology becomes more diverse and accessible, its implementation into healthcare systems can make services more efficient and help with transitioning from outdated practices to more effective protocols. Patient Recorded Outcome Measures (PROMs) and home-monitoring devices could be the key step in identifying which patients require input and help shift to more data-driven appointment scheduling based on clinical need, rather than at regular intervals of time. Virtual care and technology-driven service provision could also revolutionise outpatient systems, maintaining high quality care while improving accessibility to patients. Patient involvement and empowerment while making these changes will assist shared decision making surrounding their care and allow them to be champions of their own health, helping clinicians to provide a patient-centred service. Understanding how these may be implemented will help clinicians take an active role in the development of these practices.