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PD-1 blockade partially recovers dysfunctional virus–specific B cells in chronic hepatitis B infection
Loghman Salimzadeh, … , Patrick T.F. Kennedy, Antonio Bertoletti
Loghman Salimzadeh, … , Patrick T.F. Kennedy, Antonio Bertoletti
Published August 7, 2018
Citation Information: J Clin Invest. 2018;128(10):4573-4587. https://doi.org/10.1172/JCI121957.
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Research Article Hepatology Infectious disease

PD-1 blockade partially recovers dysfunctional virus–specific B cells in chronic hepatitis B infection

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Abstract

Chronic HBV (CHB) infection suppresses virus-specific T cells, but its impact on humoral immunity has been poorly analyzed. Here, we developed a dual-staining method that utilizes hepatitis B virus (HBV) surface antigens (HBsAg) labeled with fluorochromes as “baits” for specific ex vivo detection of HBsAg-specific B cells and analysis of their quantity, function, and phenotype. We studied healthy vaccinated subjects (n = 18) and patients with resolved (n = 21), acute (n = 11), or chronic (n = 96) HBV infection and observed that frequencies of circulating HBsAg-specific B cells were independent of HBV infection status. In contrast, the presence of serum HBsAg affected function and phenotype of HBsAg-specific B cells that were unable to mature in vitro into Ab-secreting cells and displayed an increased expression of markers linked to hyperactivation (CD21lo) and exhaustion (PD-1). Importantly, B cell alterations were not limited to HBsAg-specific B cells, but affected the global B cell population. HBsAg-specific B cell maturation could be partially restored by a method involving the combination of the cytokines IL-2 and IL-21 and CD40L-expressing feeder cells and was further boosted by the addition of anti–PD-1 Abs. In conclusion, HBV infection has a marked impact on global and HBV-specific humoral immunity, yet HBsAg-specific B cells are amenable to a partial rescue by B cell–maturing cytokines and PD-1 blockade.

Authors

Loghman Salimzadeh, Nina Le Bert, Charles-A. Dutertre, Upkar S. Gill, Evan W. Newell, Christian Frey, Magdeleine Hung, Nikolai Novikov, Simon Fletcher, Patrick T.F. Kennedy, Antonio Bertoletti

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Figure 2

Similar frequency of HBsAg-specific B cells in diverse cohorts of HBV-infected patients.

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Similar frequency of HBsAg-specific B cells in diverse cohorts of HBV-in...
(A) Frequency of HBsAg-specific B cells in 5 healthy HBV-unvaccinated (HC unvac), 18 healthy HBV-vaccinated (HC vac), 11 acute HBV, 21 resolved HBV, and 96 CHB patients out of total CD19+ B cells. (B) Frequency of HBsAg-specific B cells out of total CD19+ B cells in different phases of CHB: 22 HBeAg+ chronic infection (eAg+CInf), 24 HBeAg+ chronic hepatitis (eAg+CHep), 24 HBeAg– chronic hepatitis (eAg–CHep), and 26 HBeAg– chronic infection (eAg–CInf). (C) No correlation between frequency of HBsAg-specific B cells and serum levels of HBsAg, HBV DNA, and ALT. (D) Frequency of HBsAg-specific B cells among 51 CHB patients infected with 5 different HBV genotypes. Data are presented as median, and statistical analysis was performed by the Kruskal-Wallis test followed by Dunn’s multiple comparisons test. *P < 0.05 (A, B, and D); Spearman’s rank correlation (C).

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