Introduction: The process of immunoglobulin class switch recombination (CSR) occurs in secondary lymphoid organs. This highly regulated process is essential for the development of different antibody isotype maturation and long-life memory/plasma cell generation. Patients with impaired CSR present heterogeneous noninfectious complications.
Areas covered: We provide an overview of recent advancements in the tight regulation of B cells before and during the CSR at different levels of cytokine stimulations, intracellular signaling, transcription-factor activation, gene transcription, and epigenetic controls.
Expert opinion: Besides recurrent infections which result from the lack of production of class-switched immunoglobulins, intrinsic B cell signaling pathways and regulatory component defects have distinct roles in other immune-related clinical manifestations including autoimmunity, atopy, lymphoproliferation, and cancer.
Keywords: B cell; Primary immunodeficiency; class switch recombination; cytokines; humoral immunity; inborn errors of immunity; transcription factors.