Abstract
T lymphocytes are important in the pathogenesis of psoriasis, and increasing evidence indicates that B cells also play an important role. The mechanisms of action, however, remain unclear. We evaluated the ratios of CD19+ B cells in peripheral blood mononuclear cells (PBMCs) from 157 patients with psoriasis (65 patients with psoriasis vulgaris, 32 patients with erythrodermic psoriasis, 30 patients with arthropathic psoriasis, and 30 patients with pustular psoriasis) and 35 healthy controls (HCs). Ratios of CD19+ B cells in skin lesions were compared with non-lesions in 7 erythrodermic psoriasis patients. The Psoriasis Area Severity Index (PASI) was used to measure disease severity. CD19+ B cell ratios in PBMCs from psoriasis vulgaris (at both the active and stationary stage) and arthropathic psoriasis patients were higher compared with HCs (P<0.01), but ratios were lower in erythrodermic and pustular psoriasis patients (P<0.01). CD19+ B cell ratios in erythrodermic psoriasis skin lesions were higher than in non-lesion areas (P<0.001). Different subsets of CD19+CD40+, CD19+CD44+, CD19+CD80+, CD19+CD86+, CD19+CD11b+, and CD19+HLA-DR+ B cells in PBMCs were observed in different psoriasis clinical subtypes. PASI scores were positively correlated with CD19+ B cell ratios in psoriasis vulgaris and arthropathic psoriasis cases (r=0.871 and r=0.692, respectively, P<0.01), but were negatively correlated in pustular psoriasis (r=-0.569, P<0.01). The results indicated that similar to T cells, B cells activation may also play important roles in different pathological stages of psoriasis.
Highlights
Psoriasis is a chronic and recurrent autoimmune inflammatory skin disease, and there are strong evidences that T lymphocytes are important in its pathogenesis [1]
Proportion of CD19+ B cells The proportion of CD19+ B cells in peripheral blood mononuclear cells (PBMCs) from patients with psoriasis vulgaris and arthropathic psoriasis was higher compared with healthy controls (HCs)
The proportion of CD19+ B cells in PBMCs was lower in patients with erythrodermic psoriasis and pustular psoriasis compared with HCs
Summary
Psoriasis is a chronic and recurrent autoimmune inflammatory skin disease, and there are strong evidences that T lymphocytes are important in its pathogenesis [1]. CD4+ T cell and T helper 17 cell levels are significantly elevated in the peripheral blood of psoriasis patients, and large gd T cell infiltration has been observed in psoriasis skin lesions [2,3,4,5,6,7]. Other immune cells besides T cells, such as B lymphocytes, macrophages, monocytes, neutrophils, and natural killer (NK) cell levels are increased in psoriasis patients, and they may contribute to its pathogenesis [8]. As evidence of B cell influence in psoriasis pathogenesis, elevated levels of interleukin (IL)-21 were found in the skin lesions of patients with psoriasis [8]. B cells can help promote CD4+ T cells, and have the potential to produce IL-17, thereby contributing to the inflammation in psoriasis [10]. The exact role of B cells in the pathogenesis of psoriasis remains unclear
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