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

• Published in: Journal of allergy and clinical immunology Vol. 137; no. 1; pp. 118 - 129.e5
• Main Authors: Czarnowicki, Tali, Gonzalez, Juana, Bonifacio, Kathleen M., Shemer, Avner, Xiangyu, Peng, Kunjravia, Norma, Malajian, Dana, Fuentes-Duculan, Judilyn, Esaki, Hitokazu, Noda, Shinji, Estrada, Yeriel, Xu, Hui, Zheng, Xiuzhong, Krueger, James G., Guttman-Yassky, Emma
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2016; Elsevier Limited
• Subjects: Adult; Age; Aged; Aged, 80 and over; Allergy and Immunology; Alzheimer's disease; Antigen presentation; Antigens, CD - immunology; Atopic dermatitis; B-Lymphocyte Subsets - immunology; B cells; Dermatitis, Atopic - blood; Dermatitis, Atopic - immunology; Ethnicity; Female; Humans; Immunoglobulin E - blood; Lymphocyte Activation; Male; Middle Aged; Psoriasis; Psoriasis - immunology; T cell receptors; PASI; AD; IHC; Treg; NSM; DN; ASC; Atopic dermatitis; psoriasis; B cells; CLA; SwMe; TLR; TEM; TCM; Immunohistochemistry; Psoriasis Area and Severity Index; T CM; T EM; Nonswitched memory; Regulatory T; Central memory T; Toll-like receptor; Cutaneous lymphocyte antigen; Effector memory T; Switched memory; Antibody-secreting cell; Double negative
• ISSN: 0091-6749; 1097-6825; 1097-6825
• DOI: 10.1016/j.jaci.2015.08.027

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