B lymphocytes directly contribute to tissue fibrosis in patients with IgG4-related disease

Emanuel Della-Torre; Elena Rigamonti; Cory Perugino; Simona Baghai-Sain; Na Sun; Naoki Kaneko; Takashi Maehara; Lucrezia Rovati; Maurilio Ponzoni; Raffaella Milani; Marco Lanzillotta; Vinay Mahajan; Hamid Mattoo; Ivan Molineris; Vikram Deshpande; John H Stone; Massimo Falconi; Angelo A Manfredi; Shiv Pillai

doi:10.1016/j.jaci.2019.07.004

B lymphocytes directly contribute to tissue fibrosis in patients with IgG₄-related disease

J Allergy Clin Immunol. 2020 Mar;145(3):968-981.e14. doi: 10.1016/j.jaci.2019.07.004. Epub 2019 Jul 15.

Authors

Emanuel Della-Torre¹, Elena Rigamonti², Cory Perugino³, Simona Baghai-Sain⁴, Na Sun⁵, Naoki Kaneko⁶, Takashi Maehara⁶, Lucrezia Rovati⁷, Maurilio Ponzoni⁸, Raffaella Milani⁹, Marco Lanzillotta², Vinay Mahajan⁵, Hamid Mattoo¹⁰, Ivan Molineris⁴, Vikram Deshpande¹¹, John H Stone¹², Massimo Falconi¹³, Angelo A Manfredi¹⁴, Shiv Pillai⁵

Affiliations

¹ Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy; Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: [email protected].
² Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy.
³ Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
⁴ Center for Translational Genomics and Bioinformatics, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁵ Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
⁶ Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
⁷ Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy; Ragon Institute of MGH, MIT, and Harvard, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
⁸ Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy; Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁹ Immunohematology and Transfusion Medicine Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹⁰ Immunology and Inflammation Therapeutic Area, Sanofi, Cambridge, Mass.
¹¹ Department of Pathology, Massachusetts General Hospital, Boston, Mass.
¹² Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
¹³ Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy; Division of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹⁴ Università Vita-Salute San Raffaele, IRCCS San Raffaele Scientific Institute, Milan, Italy; Unit of Immunology, Rheumatology, Allergy, and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Abstract

Background: IgG₄-related disease (IgG₄-RD) is a fibroinflammatory condition marked by rapid clinical improvement after selective depletion of B lymphocytes with rituximab. This feature suggests that B cells might participate in fibrogenesis and wound healing.

Objective: In the present work we aimed to demonstrate that B lymphocytes contribute directly to tissue fibrosis in patients with IgG₄-RD.

Methods: Total circulating CD19⁺ B lymphocytes, naive B cells, memory B cells, or plasmablasts from patients with IgG₄-RD were cultivated with human fibroblasts. Profibrotic soluble factors and collagen production in cocultures were assessed by using ELISAs and Luminex assays. RNA sequencing and quantitative RT-PCR were used to assess fibroblast activation in the presence of B cells, as well as induction of profibrotic pathways in B-cell subsets. Relevant profibrotic and inflammatory molecules were confirmed in vitro by using functional experiments and on IgG₄-RD tissue sections by using multicolor immunofluorescence studies.

Results: B cells from patients with IgG₄-RD (1) produced the profibrotic molecule platelet-derived growth factor B and stimulated collagen production by fibroblasts; (2) expressed enzymes implicated in extracellular matrix remodeling, such as lysyl oxidase homolog 2; (3) produced the chemotactic factors CCL4, CCL5, and CCL11; and (4) induced production of these same chemokines by activated fibroblasts. Plasmablasts expressed sets of genes implicated in fibroblast activation and proliferation and therefore represent cells with intrinsic profibrotic properties.

Conclusion: We have demonstrated that B cells contribute directly to tissue fibrosis in patients with IgG₄-RD. These unanticipated profibrotic properties of B lymphocytes, particularly plasmablasts, might be relevant for fibrogenesis in patients with other fibroinflammatory disorders and for wound-healing processes in physiologic conditions.

Keywords: B cells; IgG(4); IgG(4)-related disease; fibroblasts; fibrosis; lysyl oxidase homolog 2; plasmablasts; platelet-derived growth factor; rituximab.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

B-Lymphocytes / immunology
B-Lymphocytes / pathology*
Cells, Cultured
Coculture Techniques
Collagen / biosynthesis
Fibroblasts / pathology*
Fibrosis / immunology
Fibrosis / pathology
Humans
Immunoglobulin G4-Related Disease / immunology
Immunoglobulin G4-Related Disease / pathology*
Pancreas / pathology*

Substances

Collagen

Abstract

Publication types

MeSH terms

Substances

Grants and funding