Extrafollicular B cell responses correlate with neutralizing antibodies and morbidity in COVID-19.
Nat Immunol
; 21(12): 1506-1516, 2020 12.
Article
em En
| MEDLINE
| ID: mdl-33028979
ABSTRACT
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Linfócitos B
/
Anticorpos Neutralizantes
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SARS-CoV-2
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COVID-19
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Anticorpos Antivirais
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article