Association between nonspecific interstitial pneumonia and presence of CD20+\u2009B lymphocytes within pulmonary lymphoid follicles

Min Peng,Wenze Wang,Hongrui Liu,Wenbing Xu,Mingwei Qin,Ling Qin,Yuanjue Zhu,Juhong Shi,Wenjie Zheng

doi:10.1038/s41598-017-17208-1

Abstract

Nonspecific interstitial pneumonia (NSIP) is characterised by interstitial infiltration of lymphocytes and varying amounts of interstitial fibrosis. B cells have been suggested to contribute to the pathogenesis of NSIP. However, the relationship between B-lymphocyte and the clinical outcomes of NSIP was unclear. In this study, 50 patients with histopathologically confirmed NSIP from Peking Union Medical College Hospital between April 2003 to December 2012 were retrospectively analyzed. Using immunohistochemical analyses, CD20+ B cells were counted in the lymphoid follicles, perivascular, interstitial, and peribronchiolar regions of lung tissure. The CD20+ lymphocytes were mainly present in the lymphoid follicles. The number of follicular CD20+ lymphocytes was higher in the fibrosing than cellular NSIP pattern [255.08 (132.92–449.71) vs. 121.33 (63.54–282.88)/0.1 mm2, p = 0.017]. After 1 year of therapy, the follicular CD20+ lymphocytes were significantly higher in patients whose forced vital capacity (FVC) worsened as compared to those who improved (p = 0.014). Additionally, follicular CD20+ lymphocytes were negatively correlated with the post-treatment percentage change in FVC (rho = −0.397, p = 0.004). However, follicular CD20+ lymphocytes were not correlated with survival. These results suggested that pulmonary follicular CD20+ lymphocytes were correlated with the fibrosing pattern of NSIP and predicted less clinical improvement after treatment.

Highlights

Medical College Hospital between April 2003 to December 2012 were retrospectively analyzed
Lymphocyte aggregates comprising B and T lymphocytes are present in patients with idiopathic pulmonary fibrosis (IPF)[7,8], and active cellular inflammation continues in IPF even in its severe end stage[9]
Twenty patients were diagnosed with connective tissue disease (CTD)-Nonspecific interstitial pneumonia (NSIP)

Summary

Introduction

Medical College Hospital between April 2003 to December 2012 were retrospectively analyzed. Follicular CD20+ lymphocytes were not correlated with survival These results suggested that pulmonary follicular CD20+ lymphocytes were correlated with the fibrosing pattern of NSIP and predicted less clinical improvement after treatment. Medical treatments for NSIP are typically based on glucocorticoids with or without cytotoxic agents Besides their capacity for antibody secretion, B lymphocytes act as antigen-presenting cells for T lymphocytes, provide additional co-stimulatory signals, and produce diverse inflammatory and regulatory cytokines[3,4]. Lymphocyte aggregates comprising B and T lymphocytes are present in patients with idiopathic pulmonary fibrosis (IPF)[7,8], and active cellular inflammation continues in IPF even in its severe end stage[9]. Infiltration of B and T lymphocytes is present in the lungs of patients with idiopathic NSIP10,11, rheumatoid arthritis-associated NSIP and usual interstitial pneumonia[6,12].

Methods

Results

Conclusion