Gut IgA functionally interacts with systemic IgG to enhance antipneumococcal vaccine responses

The gut microbiota enhances systemic immunoglobulin G (IgG) responses to vaccines, but it is unknown whether this effect involves IgA, which coats intestinal microbes. That IgA may amplify postimmune IgG production is suggested by the impaired IgG response to pneumococcal vaccines in some IgA-deficient patients. Here, we found that antipneumococcal but not total IgG production was impaired in mice with IgA deficiency. The positive effect of gut IgA on antipneumococcal IgG responses started very early in life and could implicate gut bacteria, as these responses were attenuated in germ-free mice recolonized with gut microbes from IgA-deficient donors. IgA could exert this effect by constraining the systemic translocation of gut antigens, which was associated with chronic immune activation, including T cell overexpression of programmed cell death protein 1 (PD-1). This inhibitory receptor may attenuate antipneumococcal IgG production by causing B cell hyporesponsiveness, which improved upon anti-PD-1 treatment. Thus, gut IgA functionally interacts with systemic IgG to enhance antipneumococcal vaccine response

High serum levels of BAFF, APRIL, and TACI in common variable immunodeficiency

Common variable immunodeficiency (CVID) is characterized by low levels of immune globulins and lack of antibody. Mutations in transmembrane activator and calcium-modulating cyclophilin ligand (TACI), are found in 8-10%, associated with autoimmunity and splenomegaly. Some patients with mutations had increased serum levels of TACI. Because of this, and the prevalence of autoimmunity, splenomegaly, and lymphadenopathy, we quantitated levels of TACI ligands, a proliferation inducing ligand (APRIL) and B cell activating factor (BAFF) and TACI in serum of 77 patients. CVID subjects had markedly increased serum levels of BAFF, (p<0.0001) APRIL (p<0.0001) and TACI (p=0.001) but there was no relationship between levels and autoimmunity, lymphadenopathy, splenomegaly, B cell numbers, or mutations in TACI. Peripheral blood mononuclear cells of CVID subjects had increased levels of BAFF mRNA. We conclude that increased constitutive production and/or underlying immuno-regulatory or inflammatory conditions leads to enhanced release of ligands, however the biological result remains unclear

Reduced serum BCMA levels distinguish patients with primary antibody deficiency

Abstract B-cell maturation antigen (BCMA) is a TNF family receptor that binds a proliferation inducing ligand (APRIL) and B cell activating factor (BAFF). BCMA is expressed by immunoglobulin secreting cells, but not other B cells, and supports their survival. Primary antibody deficiency (PAD) is the most common primary immunodeficiency and may lead to infection and complications including autoimmunity, enteropathy, lung disease, and malignancy. PAD patients with these complications have reduced survival, yet there are no validated tests to predict those at risk. We previously demonstrated that BCMA is present in the serum and its levels are elevated in patients with multiple myeloma. As BCMA is expressed by both normal and malignant antibody-producing cells, we examined serum levels of BCMA in PAD. Patients with PAD (n=68) had markedly reduced BCMA levels (median, 7.30) compared with healthy donors (n=119; median, 35.20; P &amp;lt; 0.0001). When subgrouped based upon PAD diagnosis, serum BCMA was reduced compared to controls among those with common variable immunodeficiency (CVID) (n=48; median, 7.16; P &amp;lt;0.0001) and X-linked agammaglobulinemia (n=8; median, 2.30; P &amp;lt;0.0001), but not among those with selective IgA deficiency or hyper IgM syndrome. CVID patients with any inflammatory complication, or enteropathy specifically, had significantly lower serum BCMA than CVID patients without complications (P &amp;lt; 0.01 for both). Serum BCMA moderately correlated with isotype-switched memory B cells (r = 0.473), but poorly correlated with IgA, IgG, or IgM levels or total B cell levels. These results demonstrate that reduced serum BCMA levels are found in PAD patients, distinguish types of PAD, and are associated with the development of complications in CVID.</jats:p