B cells from patients with chronic GVHD are activated and primed for survival via BAFF-mediated pathways

JL Allen, MS Fore, J Wooten, PA Roehrs… - Blood, The Journal …, 2012 - ashpublications.org
JL Allen, MS Fore, J Wooten, PA Roehrs, NS Bhuiya, T Hoffert, A Sharf, AM Deal…
Blood, The Journal of the American Society of Hematology, 2012ashpublications.org
Recent data reveal an important role for B cells in the pathogenesis of chronic GVHD
(cGVHD). Patients with cGVHD have delayed B-cell reconstitution and elevated BAFF to B-
cell ratios compared to patients without cGVHD. The mechanisms promoting and sustaining
B-cell activation in this disease, however, remain unknown. As BAFF increases murine B-
cell metabolism and survival and maintains autoreactive B-cell clones, we performed ex vivo
analyses of peripheral B cells from 51 patients who either had or did not have active cGVHD …
Abstract
Recent data reveal an important role for B cells in the pathogenesis of chronic GVHD (cGVHD). Patients with cGVHD have delayed B-cell reconstitution and elevated BAFF to B-cell ratios compared to patients without cGVHD. The mechanisms promoting and sustaining B-cell activation in this disease, however, remain unknown. As BAFF increases murine B-cell metabolism and survival and maintains autoreactive B-cell clones, we performed ex vivo analyses of peripheral B cells from 51 patients who either had or did not have active cGVHD and were greater than 1 year from the time of allogeneic hematopoietic stem cell transplantation. We found that B cells from patients with active cGVHD were in a heightened metabolic state and were resistant to apoptosis. Exogenous BAFF treatment amplified cell size and survival in B cells from these patients. We found significantly increased signaling through ERK and AKT that associated with decreased levels of proapoptotic Bim, suggesting a mechanistic link between elevated BAFF levels and aberrant B-cell survival. Thus, we identify a role for BAFF in the pathogenesis of cGVHD and define B-cell activation and survival pathways suitable for novel therapeutic development in cGVHD.
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