Diverse activation and differentiation of multiple B-cell subsets in patients with atopic dermatitis but not in patients with psoriasis

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• 作者：Tali Czarnowicki ; MD ; MSc^a ; ^{tczarnowic01@rockefeller.edu" class="auth_mail" title="E-mail the corresponding author} ; Juana Gonzalez ; PhD^b ; Kathleen M. Bonifacio ; MD^a ; Avner Shemer ; MD^c ; Peng Xiangyu ; MSc^d ; Norma Kunjravia ; MD^a ; Dana Malajian ; BA^a ; ^e ; Judilyn Fuentes-Duculan ; MD^a ; Hitokazu Esaki ; MD^a ; ^d ; Shinji Noda ; MD^a ; Yeriel Estrada ; BSc^d ; Hui Xu ; MSc^d ; Xiuzhong Zheng ; MSc^a ; James G. Krueger ; MD ; PhD^a ; Emma Guttman-Yassky ; MD ; PhD^a ; ^d
• 关键词：Atopic dermatitis ; psoriasis ; B cells
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：137
• 期：1
• 页码：118-129.e5
• 全文大小：3962 K

文摘

Atopic dermatitis (AD) and psoriasis pathogeneses involve skin barrier impairment and immune dysregulation; however, the contribution of B-cell imbalances to these diseases has not yet been determined.

Objective

We sought to quantify B-cell populations and antibody-secreting cells in the blood of patients with AD, patients with psoriasis, and control subjects.

Methods

We studied 34 adults with moderate-to-severe AD (mean SCORAD score, 65), 24 patients with psoriasis (mean Psoriasis Area and Severity Index score, 16), and 27 healthy subjects using an 11-color flow cytometric antibody panel. IgD/CD27 and CD24/CD38 core gating systems were used to determine frequencies of plasmablasts and naive, memory, transitional, and activated B cells.

Results

We measured increased CD19⁺CD20⁺ B-cell counts in the skin and blood of patients with AD (P < .01). Significantly higher frequencies of chronically activated CD27⁺ memory and nonswitched memory B cells were observed in patients with AD (P < .05), with lower values of double-negative populations (4% for patients with AD vs 7% for patients with psoriasis [P = .001] and 6% for control subjects [P = .02]). CD23 expression was highest in patients with AD and correlated with IgE levels (P < .01) and disease severity (r = 0.6, P = .0002). Plasmablast frequencies and IgE expression were highest in all memory subsets of patients with AD (P < .01). Finally, CD19⁺CD24⁺⁺CD38⁺⁺ transitional and CD19⁺CD24⁻CD38⁻ new memory B-cell counts were higher in patients with AD versus those in patients with psoriasis (2.8% vs 1.4% [P = .001] and 9.2% vs 5.7% [P = .02], respectively).

Conclusions

AD is accompanied by systemic expansion of transitional and chronically activated CD27⁺ memory, plasmablast, and IgE-expressing memory subsets. These data create a critical basis for the future understanding of this debilitating skin disease.