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Xu Y, Huang X, Li F, Liu T, Yang T, Chen F, Zhu J, Pan M, Zhang Y, Wang Y, Fu L, Xiao C, Geng D. IL-21 enhances STAT3/Blimp-1 signaling pathway in B cells and contributes to plasma cell differentiation in newly diagnosed patients with myasthenia gravis. Immunol Res 2020; 69:59-70. [PMID: 33145710 DOI: 10.1007/s12026-020-09164-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/30/2020] [Indexed: 12/21/2022]
Abstract
The transcription factor Blimp-1 is necessary for the B cell differentiation toward immunoglobulin-secreting plasma cells. However, the immunopathological mechanisms of Blimp-1 that regulates B cell differentiation remain unclear in MG. The purpose of this study was to perform a quantitative and functional analysis of Blimp-1 in MG. A total of 34 patients with MG (18 ocular MG (OMG) and 16 generalized MG (GMG) and 20 healthy controls (HC) were recruited in this study. CD19+ B cells were isolated by positive selection using CD19 beads. The expression of Blimp-1 and p-STAT3 protein in isolated B cells was assessed by Western blot. Plasma cells were analyzed by flow cytometry. Serum IL-21 levels were detected by ELISA. Our data demonstrated that Blimp-1 in peripheral blood B cell of MG patients was significantly increased compared with HC. The increased expression of Blimp-1 was positively associated with clinical severity score (QMGs), plasma cell frequency, and serum IL-21 levels. Furthermore, glucocorticoid (GC) treatment reduced the expression of Blimp-1 and p-STAT3 in B cells, and this change was accompanied with relieved clinical severity, reduced plasma cell frequency, and decreased serum IL-21 levels. In vitro assay demonstrated that IL-21 stimulation upregulated STAT3 phosphorylation, increased Blimp-1 expression in B cells, and promoted plasma cell differentiation, and these processes could be inhibited by dexamethasone or STAT3 inhibitor stattic. This work indicates for the first time that aberrant expression of Blimp-1 exists on B cells and contributes to the plasma cell differentiation in MG patients. Modulation of IL-21/STAT3/Blimp-1 signaling pathway in B cells may be one of the mechanisms of glucocorticoid in the treatment of MG.
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Affiliation(s)
- Yanan Xu
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China.,Department of Neurology, Nanjing Jiangbei People's Hospital, No. 552 Geguan Road, Jiangbei New District, Nanjing, Jiangsu, China
| | - Xiaoyu Huang
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Fengzhan Li
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Tan Liu
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Tingting Yang
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Fei Chen
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China.,Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, 32 Coal Construction Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Jie Zhu
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China.,Department of Neurology, Second Affiliated Hospital of Xuzhou Medical University, 32 Coal Construction Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Meng Pan
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China.,Department of Neurology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264 Guangzhou Road, Gulou District, Nanjing, Jiangsu, China
| | - Yong Zhang
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China.
| | - Yuzhong Wang
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Linlin Fu
- Department of Pathogenic Biology and Lab of Infection and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - Chenghua Xiao
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
| | - Deqin Geng
- Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu, China
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Teleshova N, Matusevicius D, Kivisäkk P, Mustafa M, Pirskanen R, Link H. Altered expression of costimulatory molecules in myasthenia gravis. Muscle Nerve 2000; 23:946-53. [PMID: 10842273 DOI: 10.1002/(sici)1097-4598(200006)23:6<946::aid-mus16>3.0.co;2-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
To characterize the involvement of costimulatory pathways in the pathogenesis of myasthenia gravis (MG), a multiparameter flow cytometry assay was adopted to enumerate blood mononuclear cells (MNC) expressing CD28, CD80, CD86, CD40, and CD40L molecules in patients with MG and healthy subjects. Patients with MG had lower percentages of CD8(+)CD28(+) cells, augmented percentages of CD4(+)CD80(+), CD4(+)CD86(+), CD8(+)CD80(+), CD8(+)CD86(+), CD14(+)CD80(+), and CD14(+)CD86(+) cells, and similar levels of cells expressing CD40 and CD40L and of B cells expressing CD80 and CD86 compared to the controls. Patients with early onset of MG (<40 years) had lower percentages of CD3(+)CD86(+), CD4(+)CD86(+), CD8(+)CD86(+) T cells and CD20(+)CD86(+) B cells compared to those with late onset (>40 years). There was a positive correlation between the patients' age and percentages of CD86(+) cells. The data indicate that the CD28/CD80-CD86 costimulatory pathway is involved in MG. The high percentages of CD80 and CD86 positive T cells and monocytes may reflect persistent activation of T and B cells, whereas the low CD28 expression may be the result of chronic exposure to CD80 and CD86. These molecules could be the focus for new and improved immunomodulating therapies of MG.
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Affiliation(s)
- N Teleshova
- Department of Neurology, Neuroimmunology Unit, Karolinska Institutet, Huddinge University Hospital, S-14186 Huddinge, Sweden.
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Ragheb S, Bealmear B, Lisak R. Cell-surface expression of lymphocyte activation markers in myasthenia gravis. Autoimmunity 1999; 31:55-66. [PMID: 10593570 DOI: 10.3109/08916939908993860] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
An analysis of the cell-surface expression of activation markers on B- and T-cells was done to compare patients with myasthenia gravis (MG) and healthy non-myasthenic controls. Marker expression was determined by immunostaining of peripheral blood mononuclear cells (PBMC) isolated from MG patients and from controls. The percentage of B-cells in PBMC that expressed CD71, a transferrin receptor, was significantly greater in patients compared to controls, particularly, in patients who were seropositive for acetylcholine receptor-specific antibodies. When subgroups of MG patients were studied, our data showed that within the first year after disease onset, patients had a significantly higher percentage of T-cells in PBMC that were CD25+ (interleukin-2 receptor alpha) and CD26+ (dipeptidyl peptidase IV ectoenzyme) in comparison to patients with disease symptoms for longer than one year and to healthy controls. Our data also showed that patients with generalized MG had significantly lower percentages of gamma/delta T-cells in peripheral blood compared to healthy controls. The results of this study demonstrate important differences in the cell-surface expression of lymphocyte markers between MG patients and healthy non-myasthenic controls. In addition, differences between subgroups of patients demonstrate that patients with MG are heterogeneous in clinical presentation and in immunological parameters.
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MESH Headings
- Adult
- Age of Onset
- Antigens, CD/analysis
- Antigens, Differentiation, B-Lymphocyte/analysis
- Autoantibodies/blood
- B-Lymphocytes/immunology
- Humans
- Lymphocyte Activation/immunology
- Middle Aged
- Myasthenia Gravis/immunology
- Myasthenia Gravis/pathology
- Receptors, Antigen, T-Cell, alpha-beta/analysis
- Receptors, Antigen, T-Cell, gamma-delta/analysis
- Receptors, Cholinergic/immunology
- Receptors, Transferrin/analysis
- T-Lymphocytes/immunology
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Affiliation(s)
- S Ragheb
- Department of Neurology, Wayne State University, and The Detroit Medical Center, MI 48201, USA.
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Heidenreich F, Jovin T. Synthesis of anti-acetylcholine receptor antibodies by CD5- B cells from peripheral blood of myasthenia gravis patients. J Neurol 1996; 243:57-62. [PMID: 8869388 DOI: 10.1007/bf00878532] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An increased frequency of CD5+ B cells (or, according to a new nomenclature, B1 cells) has been detected in the peripheral blood of a proportion of patients with myasthenia gravis (MG), as in some other autoimmune diseases. To elucidate the pathogenic significance of this B-cell subset in myasthenia gravis, mononuclear cells from the peripheral blood of six MG patients were separated into T and B lymphocytes by a magnetic cell separation procedure employing superparamagnetic microbeads (MACS). Subsequently, the B-cell fraction was depleted of CD5+ B cells in a second separation. The resulting purified CD5- B-cell fraction was cultured alone or with the addition of autologous T cells. Anti-acetylcholine receptor (AChR) synthesis by CD5- B cells in cultures with T cells was significantly increased by pokeweed mitogen (176 +/- 130 fmol/ml per week/2 x 10(5) B cells) compared with unfractionated cells (75 +/- 101) or CD5- B cells alone (19 +/- 4). These results demonstrate that in MG anti-AChR are synthesized, at least in part, by CD5- B cells which are dependent on T cells. Although this does not exclude the existence of AChR-specific CD5+ B cells, it provides evidence against a pivotal role of this B-cell subset in anti-AChR synthesis.
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Affiliation(s)
- F Heidenreich
- Department of Neurology, Heinrich-Heine University, Düsseldorf, Germany
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