Background
B cells play many roles in health and disease. However, little is
known about the mechanisms that drive B cell responses in the airways,
especially in humans. Chronic rhinosinusitis (CRS) is an inflammatory
disease of the upper airways that affects 10% of Europeans and
Americans. A subset of CRS patients develop nasal polyps (NP), which are
characterized by type 2 inflammation, eosinophils and group 2 innate
lymphoid cells (ILC2). We have reported that NP contain elevated levels of B
cells and antibodies, making NP an ideal system for studying B cells in the
airways.
Objective
We sought to determine the mechanisms that drive B cell activation
and antibody production during chronic airway inflammation.
Methods
We analyzed B cells from NP or tonsil, or after ILC2 co-culture, by
flow cytometry. Antibody production from tissue was measured using Luminex
assays, and the frequency of antibody-secreting cells by ELISpot. Formation
of B cell clusters was assessed using immunohistochemistry. Expression of
genes associated with B cell activation and class switch recombination was
measured by qRT-PCR.
Results
NP contained significantly elevated frequencies of plasmablasts,
especially those that expressed the extra follicular marker Epstein-Barr
virus-induced protein 2 (EBI2), but significantly fewer germinal center (GC)
B cells compared to tonsil. Antibody production and the frequency of
antibody-secreting cells were significantly elevated in NP, and there was
evidence for local class switch recombination in NP. Finally, ILC2s directly
induced EBI2 expression on B cells in vitro.
Conclusions and Clinical Relevance
Our data suggest there is a unique B cell activation environment
within NP that is distinct from classic GC-mediated mechanisms. We show for
the first time that ILC2s directly induce EBI2 expression on B cells,
indicating that ILC2s may play an important role in B cell responses. B
cell-targeted therapies may provide new treatment options for CRSwNP.