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Schwarz A, Balint B, Korporal-Kuhnke M, Jarius S, von Engelhardt K, Fürwentsches A, Bussmann C, Ebinger F, Wildemann B, Haas J. B-cell populations discriminate between pediatric- and adult-onset multiple sclerosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 4:e309. [PMID: 28053999 PMCID: PMC5182056 DOI: 10.1212/nxi.0000000000000309] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/31/2016] [Indexed: 12/20/2022]
Abstract
Objective: To comparatively assess the B-cell composition in blood and CSF of patients with pediatric-onset multiple sclerosis (pedMS) and adult-onset multiple sclerosis (adMS). Methods: In this cross-sectional study, we obtained blood and CSF samples from 25 patients with pedMS (8–18 years) and 40 patients with adMS (23–65 years) and blood specimens from 66 controls (1–55 years). By using multicolor flow cytometry, we identified naive, transitional, isotype class-switched memory, nonswitched memory, and double-negative memory B-cell subsets as well as plasmablasts (PB) and terminally differentiated plasma cells (PC). Flow cytometric data were compared to concentrations of B-cell-specific cytokines in serum and CSF as determined by ELISA. Results: Frequencies of circulating naive B-cells decreased with higher age in controls but not in patients with multiple sclerosis (MS). B-cell patterns in CSF differed between pedMS and adMS with an acute relapse: in pedMS-derived CSF samples, high frequencies of nonswitched memory B cells and PB were present, whereas class-switched memory B cells and PC dominated in the CSF of patients with adMS. In pedMS, PB were also elevated in the periphery. Accumulation of PB in the CSF correlated with high intrathecal CXCL-13 levels and augmented intrathecal synthesis of immunoglobulin G and immunoglobulin M. Conclusions: We demonstrate distinct changes in intrathecal B-cell homeostasis in patients with pedMS during active disease, which differ from those in adults by an expansion of plasmablasts in blood and CSF and similarly occur in prototypic autoantibody-driven autoimmune disorders. This emphasizes the particular importance of activated B-lymphocyte subsets for disease progression in the earliest clinical stages of MS.
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Affiliation(s)
- Alexander Schwarz
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Bettina Balint
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Mirjam Korporal-Kuhnke
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Sven Jarius
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Kathrin von Engelhardt
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Alexandra Fürwentsches
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Cornelia Bussmann
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Friedrich Ebinger
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Brigitte Wildemann
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
| | - Jürgen Haas
- Molecular Neuroimmunology Group (A.S., B.B., M.K.-K., S.J., B.W., J.H.), Department of Neurology, University Hospital of Heidelberg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders (B.B.), UCL Institute of Neurology, London, UK; Department of Pediatric Neurology (K.v.E., A.F., C.B., F.E.), University Children's Hospital, Heidelberg; Department of Pediatrics (A.F.), University Medical Center Hamburg-Eppendorf, Hamburg; Child Neurology Practice (C.B.), ATOS Clinic Heidelberg; and Department of Child and Adolescent Medicine (F.E.), St. Vincenz-Krankenhaus, Paderborn, Germany
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