Hantavirus infection-induced B cell activation elevates free light chains levels in circulation

PLoS Pathog. 2021 Aug 11;17(8):e1009843. doi: 10.1371/journal.ppat.1009843. eCollection 2021 Aug.

Abstract

In humans, orthohantaviruses can cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). An earlier study reported that acute Andes virus HPS caused a massive and transient elevation in the number of circulating plasmablasts with specificity towards both viral and host antigens suggestive of polyclonal B cell activation. Immunoglobulins (Igs), produced by different B cell populations, comprise heavy and light chains; however, a certain amount of free light chains (FLCs) is constantly present in serum. Upregulation of FLCs, especially clonal species, associates with renal pathogenesis by fibril or deposit formations affecting the glomeruli, induction of epithelial cell disorders, or cast formation in the tubular network. We report that acute orthohantavirus infection increases the level of Ig FLCs in serum of both HFRS and HPS patients, and that the increase correlates with the severity of acute kidney injury in HFRS. The fact that the kappa to lambda FLC ratio in the sera of HFRS and HPS patients remained within the normal range suggests polyclonal B cell activation rather than proliferation of a single B cell clone. HFRS patients demonstrated increased urinary excretion of FLCs, and we found plasma cell infiltration in archival patient kidney biopsies that we speculate to contribute to the observed FLC excreta. Analysis of hospitalized HFRS patients' peripheral blood mononuclear cells showed elevated plasmablast levels, a fraction of which stained positive for Puumala virus antigen. Furthermore, B cells isolated from healthy donors were susceptible to Puumala virus in vitro, and the virus infection induced increased production of Igs and FLCs. The findings propose that hantaviruses directly activate B cells, and that the ensuing intense production of polyclonal Igs and FLCs may contribute to acute hantavirus infection-associated pathological findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / blood
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / pathology*
  • B-Lymphocytes / immunology*
  • Hantavirus Infections / blood
  • Hantavirus Infections / immunology*
  • Hantavirus Infections / virology
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light Chains / immunology
  • Lymphocyte Activation / immunology*
  • Orthohantavirus / immunology*

Substances

  • Immunoglobulin Light Chains

Grants and funding

This study was supported by Academy of Finland (www.aka.fi) (grant numbers 308613 and 321809) to JH and TS, Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital to JM, Sigrid Juselius Foundation to JM and AV, Magnus Ehnrooth Foundation to AV, Foundation for Clinical Chemistry Research to SH, Laboratoriolääketieteen Edistämissäätiö to SH and Suomalais-Norjalainen Lääketieteen Säätiö to SH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.