Increased IgA Expression in Lung Lymphoid Follicles in Severe Chronic Obstructive Pulmonary Disease

Am J Respir Crit Care Med. 2019 Mar 1;199(5):592-602. doi: 10.1164/rccm.201802-0352OC.

Abstract

Rationale: Accumulation of B cells and lymphoid follicles (LFs) has been described in chronic obstructive pulmonary disease (COPD) airways, but the functional status of lung B cells remains poorly known.

Objectives: To characterize LFs for expression of IgA, the main mucosal antibody.

Methods: The presence of B cells and LFs, including intrafollicular IgA expression, were determined in the lung from patients with COPD (n = 37) versus control subjects (n = 34) by immunohistochemistry. We also evaluated follicular IgA responses in the lungs from mice infected with Pseudomonas aeruginosa (PAO1) (n = 10 per group) and in smoking mice.

Measurements and main results: Whereas in smokers B-cell numbers slightly increased, robust increases in B-cell and LF numbers (mainly in distal airways) were only observed in severe COPD. Most follicular B cells were IgM+ (70-80%), but IgA+ (and not IgG+) B-cell numbers were increased in LFs from severe COPD compared with control subjects (twofold, 44.7% vs. 25.2%), and this was significant in distal but not proximal airways. Follicular IgA response was also observed in PAO1-infected mouse lungs, but not after smoke exposure. Moreover, follicular IgA expression associated with expression of IL-21, which was very potent to activate immunoglobulin production in vitro.

Conclusions: This study shows that IgA production occurs in peribronchiolar LFs from severe COPD, where IL-21-producing T cells are present, and presumably represents a feature of exacerbated mucosal adaptive immune responses against microbial and/or self-antigens.

Keywords: B lymphocytes; COPD; IgA; lymphoid follicles.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • B-Lymphocytes / immunology
  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology
  • Case-Control Studies
  • Disease Models, Animal
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescent Antibody Technique
  • Humans
  • Immunoglobulin A / metabolism*
  • Interleukin-6 / metabolism
  • Interleukins / metabolism
  • Lung / immunology*
  • Lung / metabolism
  • Lung / pathology
  • Male
  • Mice, Inbred C57BL
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / immunology*
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Real-Time Polymerase Chain Reaction
  • Smoking / adverse effects
  • Smoking / metabolism
  • Smoking / pathology
  • Tertiary Lymphoid Structures / immunology*
  • Tertiary Lymphoid Structures / metabolism
  • Tertiary Lymphoid Structures / pathology

Substances

  • Immunoglobulin A
  • Interleukin-6
  • Interleukins
  • interleukin-21