bioRxiv · 10.1101/2023.09.11.557079
The extrafollicular B cell response is a hallmark of childhood idiopathic nephrotic syndrome.
Abstract
An autoimmune B cell origin for childhood idiopathic nephrotic syndrome (INS) is predicted based on the efficacy of rituximab (RTX) at maintaining long-term remission from proteinuria. Knowledge regarding the nature of the culprit B cell response is very limited. Using single-cell RNA-sequencing, we demonstrate that a B cell transcriptional program poised for effector functions represents the major immune perturbation in the blood of children with active INS. This was conferred by the engagement of an extrafollicular B cell response marked by the expansion of atypical B cells (atBCs), marginal zone-like B cells, and antibody-secreting cells (ASCs). In flow-based analyses of blood from 13 children with active INS and 24 healthy donors, this was reflected by the proliferation of RTX-sensitive extrafollicular (CXCR5-) CD21low T-bet+ CD11c+ atBCs, and short-lived T-bet+ ASCs. Together, our study provides evidence for an extrafollicular origin for humoral immunity in active INS.
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Al-Aubodah, T.-A., Aoudjit, L., Pascale, G., Perinpanayagam, M., Langlais, D., Bitzan, M., Samuel, S. M., Piccirillo, C. A., Takano, T.. 2023-09-15. The extrafollicular B cell response is a hallmark of childhood idiopathic nephrotic syndrome.. https://doi.org/10.1101/2023.09.11.557079
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