Abstract

Persistent central nervous system (CNS) inflammation, as seen in chronic infections or inflammatory demyelinating diseases such as Multiple Sclerosis (MS), results in the accumulation of various B cell subsets in the CNS, including naïve, activated, memory B cells (Bmem), and antibody secreting cells (ASC). However, factors driving heterogeneous B cell subset accumulation and antibody (Ab) production in the CNS compartment, including the contribution of ectopic lymphoid follicles (ELF), during chronic CNS inflammation remain unclear and is a major gap in our understanding of neuroinflammation. We sought to address this gap using the Theiler's murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD) model of progressive MS. In this model, injection of the virus into susceptible mouse strains results in a persistent infection associated with demyelination and progressive disability. During chronic infection, the predominant B cell phenotypes accumulating in the CNS were isotype-switched B cells, including Bmem and ASC with naïve/early activated and transitional B cells present at low frequencies. B cell accumulation in the CNS during chronic TMEV-IDD coincided with intrathecal Ab synthesis in the cerebrospinal fluid (CSF). Mature and isotype-switched B cells predominately localized to the meninges and perivascular space, with IgG isotype-switched B cells frequently accumulating in the parenchymal space. Both mature and isotype-switched B cells and T cells occupied meningeal and perivascular spaces, with minimal evidence for spatial organization typical of ELF mimicking secondary lymphoid organs (SLO). Moreover, immunohistological analysis of immune cell aggregates revealed a lack of SLO-like ELF features, such as cell proliferation, cell death, and germinal center B cell markers. Nonetheless, flow cytometric assessment of B cells within the CNS showed enhanced expression of activation markers, including moderate upregulation of GL7 and expression of the costimulatory molecule CD80. B cell-related chemokines and trophic factors, including APRIL, BAFF, CXCL9, CXCL10, CCL19, and CXCL13, were elevated in the CNS. These results indicate that localization of heterogeneous B cell populations, including activated and isotype-switched B cell phenotypes, to the CNS and intrathecal Ab (ItAb) synthesis can occur independently of SLO-like follicles during chronic inflammatory demyelinating disease.

Highlights

  • The presence of antibody (Ab), antibody-secreting cells (ASC), and multiple other B cell subsets in the central nervous system (CNS) compartment are hallmarks of chronic inflammatory processes during persistent infection or demyelinating diseases

  • In the inflammatory demyelinating disease Multiple Sclerosis (MS), CNS-infiltrating B cells are associated with the presence of oligoclonal IgG bands in the cerebrospinal fluid (CSF), a diagnostic hallmark in 95% of patients resulting from intrathecal antibody (ItAb) production in the CNS compartment [1,2,3]

  • Our experiments focused on elucidating B cell phenotypes and factors promoting persistent accumulation in the CNS compartment during chronic Theiler’s murine encephalomyelitis virus (TMEV)-IDD

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Summary

Introduction

The presence of antibody (Ab), antibody-secreting cells (ASC), and multiple other B cell subsets in the CNS compartment are hallmarks of chronic inflammatory processes during persistent infection or demyelinating diseases. The success of B cell depletion therapies (BCDT) targeting CD20+ B cells, including mature B cells to plasmablasts, have further implicated B cells in MS pathogenesis, as BCDT reduces the formation of new inflammatory lesions and relapses in relapsing-remitting MS (RRMS) patients and time to confirmed disease progression in young, inflammatory primary progressive MS (PPMS) patients with minimal effects on ItAb [8,9,10,11,12] These findings implicate a critical, yet unclear role for multiple B cell phenotypes in MS pathogenesis. The mechanisms underlying the recruitment and survival of diverse B cell populations in the CNS as well as factors responsible for fostering Ab production within the CNS compartment in MS and other chronic neuroinflammatory diseases are still largely undetermined

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