Abstract
Memory B cells play an important role in immunity to pathogens as these cells are poised to rapidly differentiate into antibody-secreting cells upon antigen re-encounter. Memory B cells also develop over the course of HLA-sensitization during pregnancy and transplantation. In this review, we discuss the potential contribution of memory B cells to pregnancy sensitization as well as the impact of these cells on transplant candidacy and outcomes. We start by summarizing how B cell subsets are altered in pregnancy and discuss what is known about HLA-specific B cell responses given our current understanding of fetal antigen availability in maternal secondary lymphoid tissues. We then review the molecular mechanisms governing the generation and maintenance of memory B cells during infection – including the role of T follicular helper cells - and discuss the experimental evidence for the development of these cells during pregnancy. Finally, we discuss how memory B cells impact access to transplantation and transplant outcomes for a range of transplant recipients.
Highlights
Pregnancy represents the most common alloimmune exposure in humans
Exposure to non-self antigens of paternal origin can prime maternal B cells to generate antibodies, and maternal production of antibody against fetal antigens can occur after immunization with either minor or major antigens [i.e. human leukocyte antigen (HLA)]
We use the term pregnancy alloimmunization to describe the response of any maternal adaptive immune subset to fetal antigen during pregnancy, whereas the term pregnancy sensitization refers to the generation of alloantibody
Summary
Reviewed by: Sebastiaan Heidt, Leiden University, Netherlands Christina Herrera, University of North Carolina at Chapel Hill, United States. Memory B cells play an important role in immunity to pathogens as these cells are poised to rapidly differentiate into antibody-secreting cells upon antigen re-encounter. Memory B cells develop over the course of HLA-sensitization during pregnancy and transplantation. We discuss the potential contribution of memory B cells to pregnancy sensitization as well as the impact of these cells on transplant candidacy and outcomes. We review the molecular mechanisms governing the generation and maintenance of memory B cells during infection – including the role of T follicular helper cells - and discuss the experimental evidence for the development of these cells during pregnancy. We discuss how memory B cells impact access to transplantation and transplant outcomes for a range of transplant recipients
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