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6. Antigen specific B cell response Activation of both T and B lymphocytes has dual goals. Firstly, these lymphocytes protect the body in a current infection, on the other hand these cells generate long-lived antigen specific cells to ensure memory capacity of adaptive immunity, thus prepare the immune system for a reinfection. While the sooner response is better in the first point, there is no time limit to create responding cells for memory response. The goal of the secondary response, is the production of antibodies with the highest affinity. Accordingly B cell activation results in: 1. early production of antibodies, to recognize and neutralise the antigen or to opsonize it to facilitate the innate immune reactions. 2. the production of memory B cells and long-lived plasma cells, which cell populations ensure the high affinity interaction with the antigen. 1. Antigen entry to the secondary lymphatic organs Naive lymphocytes practically encounter the antigens in the secondary lymphoid organs, which provide the proper environment for the extreme proliferation of both types of lymphocytes. For B cells, mostly follicular dendritic cells (FDCs) display the antigens in the germinal centers, but it is not yet fully clear how do the antigens enter the follicles and how are positioned on the FDCs. Unlike T cells, B cells are able to recognize nearly all molecule types, ranging from living bacteria to degraded products of macromolecules. The endothelium lining is not tightly packed in the sinusoid layer of the lymphatic vessels in the lymph nodes, thus smaller antigens can move directly to the secondary lymphatic organs. Larger antigens can get to the lymph nodes as part of the immune complexes. The complexes seem to be predominantly cell surface associated. Antigens opsonized by immunoglobulins or complement proteins are fixed to the cell surface by Fc and complement receptors. Macrophages, dendritic cells, non-antigen specific B cells, capture immune complexes in this way and deliver the antigen to the lymph nodes. (Red blood cells play also crucial role in the transport of blood borne immune complexes to the spleen) Antigens arriving at the lymph node localize to the surface of FDCs, where they will be arrested due to high complement and Fc receptor expression on FDCs. Once immune complexes reside on FDCs, FCDs have the unique property of retaining them on their surface for long periods of time. In summary the transport of immune complexes and their attachment to the FDCs are regulated by non-antigen specific receptors. 2. T-independent B cell response 1 B cells are able to recognize various antigen substances, T cell activation is restricted to peptide recognition (presented by MHC molecules). Accordingly, T-dependent and T-independent B cell responses are highly different. Effective B cell memory response cannot be generated without the help of T cells, thus, memory B cells develop principally to protein antigens. B cell response will be less intense in the absence of T cell-mediated helper signals, than the Tdependent response. This process results in low affinity antibodies, defective in class switching and generates weak memory response. Two main classes of T-independent responses are distinguished: T-independent I (TI-1): PRRs or complement receptors expressed on the surface of B lymphocytes can recognize the antigen or opsonins attached to it. These co-receptors signalise simultaneously with the BCR in a synergistic manner. T independent II (TI-2): B-cell response to TI-2 antigens are critically dependent on the formation of high number of antigen receptor clusters, generating extremely intense BCR signal. B1 B cells and marginal zone B cells are the main types of the T-independent response: B1 cells are a unique B cell population with innate like function. Unlike other B cells, B1 cells produce antibody independently of the presence of antigen. These natural antibodies recognize conserved, frequently expressed molecules of pathogens, similarly to the function of PRRs. As a result of these processes, these natural antibody molecules present in the serum prior to infection. B1 cells produced antibodies are low affinity IgM molecules and recognize the same antigens in everyone, being specific to conserved motifs. Marginal zone B cells localize characteristically in the marginal zone of the spleen. These B cells are activated firstly upon the appearance of the antigen; they differentiate to plasma cells and produce antibodies in 1-2 days. In this case, the produced antibodies are also low affinity IgM molecules (IgG can appear). 3. T-dependent B cell activation Due to the interaction with T cells, a part of B cells differentiate into extrafollicular plasma cells to provide quick protection, other part of B cells differentiate to memory B cells or long-lived plasma cells in a multi- step, time consuming process in germinal centers. 3.1 Extrafollicular B cell activation Hematopoiesis results in a B-cell repertoire of around 107-9 distinct binding specificities daily in the bone marrow, directed by the mechanism of V(D)J recombination. This mechanism occurs independently of antigens and results in the generation of clonally defined variable region in both 2 the heavy and light chain Ig genes. The primary repertoire has such complexity, that only a very small fraction (less than 0.01%) of the B cell clones are recruited into a response against particular foreign epitopes. T-dependent B cell activation may result in B cell activation in extrafollicular focuses or in GCs within the B cell follicles. The highest affinity B cells differentiate to extrafollicular B cells upon antigen recognition, while the lower affinity, but still antigen specific B cells enter the germinal centers. B cell proliferation begins within 1–2 days at the T zone–follicle junction of the germinal centers, where the activated B cells are distributed in a perifollicular pattern. Upon antigen recognition extrafollicular B cells proliferate, and differentiate into plasma cells in a few days. The key role of the extrafollicular activation is the early activation of B cells, this early antibody response facilitates the pathogen clearance and creates immune complexes. Extrafollicular B cell activation can bring about the differentiation into memory B cells, and isotype switching from IgM to IgG, during the perifollicular B cell proliferation phase, but these early B cells have not yet undergone SHM, thus do not improve the affinity of antibodies during the response. Extrafollicular B cell activation is a type of T dependent B cell response, to protect the body in a current infection. Following the encounter with an arriving antigen, the activated B cells move toward the T cell zone and present the specific antigen to T cells, which have already been activated by DCs. B–T cell interactions are not limited to antigen-specific (cognate) interactions between the T cell receptor (TCR) and peptide-MHCII on B cells. The TCR-induced membrane protein CD40 ligand (CD40L), that activates CD40 receptor on B cells, is the most important T cell–derived signal. CD40L signal promotes the survival and the proliferation of B cells, and it is required for isotype switch and somatic hypermutation. In addition to cell–cell interactions, CD4+ T cells provide help for B cell activation by secreting cytokines, including IL-4 and IL-21. 3.2 The development of secondary follicles While the originally high-affinity B cells provide rapid protection, the low-affinity, but antigen specific B cells accumulate as germinal center cells. This part of antigen specific B cells enters to the primary follicles upon the interaction with T cells and following clonal proliferation establish secondary follicles, germinal centers (GC). GC are normally transient structures. GC B cells appear rapidly, within 48 h in some responses, but the follicles typically reach maximum size 1–2 weeks after the delivery of an antigen. Even though a large number of naive B cells out have the cell-intrinsic potential to go into a GC reaction (polyclonal response), entry into the GC is a competitive procedure. The presence of high-affinity competitors inhibiting the activation of lower-affinity B cells prior to GC formation. Higher-affinity cells arriving to the GCs can 3 efficiently outcompete the original clones, ultimately replacing the lower-affinity clones that initiated the reaction. Finally, GCs are colonized by a very small number of high-affinity precursors. (oligoclonal response). 3.3 The role of FDC in antigen specific B cell reactions B cells are selected by antigens displayed on the FDC surface in the form of immune complexes. FDCs are characteristic stromal cells within lymph nodes. FDCs are just named dendritic cells, due to similar morphology, but they have completely different function. These cells are not derived from myeloid progenitors in the bone marrow and they do not express MHC class II molecules and only a very few of PRRs. FDCs practically cannot recognize free antigens, but are very good at binding and retaining opsonized antigens. FDCs have only a minor role in B cell homeostasis within resting lymph nodes, forming reticular networks in primary follicles. However, FDCs play a fundamental role in secondary follicles upon antigen exposure: FDCs act as long-term reservoirs of intact antigens, provide survival and co-signals for the B cells and direct their movement, both by cell surface receptors and cytokines FDCs act as long-term reservoirs retaining intact antigens on their surface in the form of immune complexes (so called iccosomes). Immune complex trapping relies primarily on complement receptors and secondly by Fc receptors. FDCs can retain antigens and display it to B cells for extended periods of time, even for several months. Immune complexes on FDCs bring the possibility that GC B cells receive multiple stimulatory signals that depend on their interaction with the antigen, but that are delivered via receptors other than the BCRs. These include signals delivered from complement fragments deposited on the immune complexes via complement receptors on B cells. These signals are likely to make an important contribution to the selection of high-affinity B cells in the GC. In addition, synapses are formed between FDCs and B cells, which are ensured by the interactions of complementary pairs of intercellular adhesion molecules such as ICAM-1 ⁄ LFA-1 and VCAM-1 ⁄ VLA-1. FDCs are thought to support GCs by secreting chemokines and cytokines that attract and sustain GC B cells. CXCL13 is the major chemoattractant both for B cells and special T cell subpopulation, the follicular helper T cells (TFH). This chemokine helps for CXCR5 expressing B cells to localize in the GC. FDCs produce an array of cytokines, most notably IL-6 and BAFF, both of which may play a role in the GC reaction, supporting B cell survival and coordinating the germinal center reaction. 4 3.4 Follicular helper T cells GCs predominantly consist of B cells but also contain FDCs and CD4+ T cells. (Specialized form of macrophages can also be found in the GC, these cells able to engulf and eliminate apoptotic B cells, those are frequent products of GC selection.) Only a small fraction of the cells in GCs are T cells (Approximately 5–20%), nevertheless, these cells are essential for GC maintenance and for affinity maturation. As for the extrafollicular interactions with T cells at the initiation of B cell activation, the interplay with T cells is also required for GC formation and for selection of somatically mutated GC B cells. The specific T cell population in the GC is known as T follicular helper (TFH) cells. Activation of CD4+ T cells allow these T cells to enter into the B cell follicle. TFH cells express special costimulatory receptors to regulate the interaction with B cells. (For example inducible T cell co-stimulator (ICOS), programmed cell death 1 (PD1) and signalling lymphocyte-activation molecule (SLAM)) These interactions with the appropriate receptors on B cells promote the differentiation of T cells into TFH cells and play a crucial role in IL-21 production. The cell-cell interactions between B cells and helper T cells together with IL-21, produced by TFH cells, are essential for survival and proliferation of GC B cells, and direct plasma cell differentiation of B cells. TFH cells also release other kind of cytokines to determine the isotype of the antibodies during class switch. 3.5 B cell selection in germinal centers The time consuming selection of the highest affinity B cells takes place in the germinal centres of the secondary lymphatic tissues. B selection in GCs operates on the basis of the relative affinity of competing clones. GC B cells with the highest affinity for an antigen, preferentially receive survival and proliferative signals, guiding their selection. Low-affinity cells are incapable of forming GCs in the presence of higher-affinity competitors, since high affinity cells can consume all antigens or at least block access to the antigen rich sites on FDCs. The amount of antigen available for lower affinity cells would be insufficient to trigger a BCR signal strong enough to rescue these cells from apoptosis, and the absence of BCR-mediated signaling leads to their elimination. BCR stimulus alone is not sufficient for affirmative selection, without T cell help it rapidly kills rather than propagates GC B cells. Proliferation of antigen-activated B cells requires also CD4+ T helper-mediated signals. T cell provides activator signals only for those B cells, which present antigen to the antigen specific T cells. Antigen presentation to the T cells requires BCR-mediated internalization of foreign antigen, its processing into peptide fragments, and its presentation to cognate T cells residing in the GCs conjunction. The BCR captures and mediates the internalization of different amounts of antigens from FDCs, in proportion to its affinity. BCR 5 affinity determines not only the intensity of BCR signaling, but also the effectivity of antigen presentation. T-cell signals are primarily delivered via CD40 ligand as well as T cell derived cytokines, such as IL-4, IL-5, IL-13, and IL-21. In summary higher affinity B cells (1) can encounter more antigens on the surface of FDCs, competing with other opponent, (2) receive stronger BCR signals, (3) present more antigens to Th cells and thus receive more Th signals. Only B cells that obtain both BCR signals and T cell help can survive, and start proliferation. The reduced ability of low-affinity B cells to compete with high affinity B cells, could be due to impaired access to antigens, or T cell help, or both of these signals. 3.6 Somatic hypermutation and affinity maturation Antigen-induced BCR signalization and the simultaneous T cell-mediated helper signals results in the selection of high-affinity B cells. The highest affinity B cells are the winners of the competitions for antigens, and are able to present the antigen for T cells effectively. Interactions with T cell activate the CD40-induced signaling, which leads to the synthesis of activation-induced deaminase (AID) in B cells, an enzyme that is required for somatic mutation and isotype switching. Somatic hyper mutation (SHM) leads to diversification of Ig variable region. Beside the bone marrow localized mechanism of V(D)J recombination, SHM also has an enormous impact on shaping the BCR repertoire. Point mutations in antibody V regions are induced due to AID activity in B cells, as a result, yield different affinities to the developing clones. (In plasmablasts, Ig V genes undergo point mutations at an extremely high rate, which are about a million times higher than the spontaneous rate of mutation in other mammalian genes.) SHM is a random process generating profitable but also unprofitable mutations. After clonal proliferation and somatic mutations, the generated clones compete for antigen access and for T cell help again. Those, that have improved affinity to the antigen during SHM compete over the strength lost clones and dominate antibody production. Whereas higher-affinity cells are selectively expanded, loweraffinity cells are eliminated by apoptosis. In GCs B cell clones have an increasingly higher average affinity for the immunizing antigen, calling the process ‘affinity maturation’. At the end of the process the affinity of GC B cells go high above the affinity of extrafollicular B cells. 3.7 Isotype switch Interaction with T cells also induces isotype switch, a process that modulates the effector functions of the produced antibodies. Firstly, naïve B cells express immunoglobulins IgM and IgD classes, 6 but after activation they can change their heavy chain classes to IgG, IgE, and IgA. The rearranged (VDJ) variable region is not changed, thus class switching does not affect antigen specificity. AID expression and the initiation of class switch are regulated mainly by CD40 signals. (due to the interaction with CD40L expressed on T cells) In the meantime the direct regulation of which CH region will be transcribed is determined by the cytokine environment. For example the IL-4 production of helper T cells leads to switch to IgE, IFNγ to IgG and TGFβ to IgA. 3.8 Cyclic movement of B cells between dark zone and light zone The GC is functionally polarized into a dark zone (DZ) in which B cells divide and a light zone (LZ) in which B cells are activated and selected based on their affinity to the antigen. The DZ consists almost entirely of B cells with a high nucleus-to-cytoplasm ratio, thus appearing “dark” by light microscopy. B cells in the DZ were referred to as “centroblasts” are among the fastest dividing mammalian cells, with a cell-cycle time estimated between 6 to 12 h. In contrast, B cells in the LZ are mingled among T cells and the network of FDCs. As antigen is deposited on the FDC network, the presence of antigens is characteristic only in the LZ. The regulation of B cell activation and selective T cell signals for high-affinity mutants located in the LZ of the GC Antigen engagement and selection are executed in the LZ while cell proliferation and SHM passes in the DZ, which requires that GC B cells transit between the two zones. Accordingly, B cells were found to constantly migrate between the two GC compartments. A fraction of B cells positively selected by survival and activation signal in the LZ would return to the DZ for further rounds of proliferation and mutation, and go again to the LZ for selection in a cyclic fashion. The decision to return to the DZ and undergo clonal expansion is controlled by T helper cells in the LZ, which discern between LZ B cells based on the amount of antigen captured and presented. B cell affinity increases in a stepwise fashion with each additional cycle, suggesting multiple rounds of selection. 3.9 Generation of long-lived plasma cells and memory B cells The positively selected germinal center B cells have three options following the interaction with T cells. These cells may start a (1) new cycle re-entering the GC reaction for further diversification, finally GC cells can be exported from the GC as (2) plasma cells or as (3) memory B cells. These two cell types ensure protection almost exclusively in reinfection. Long-lived plasma cells As a final outcome, GC B cells can differentiate into memory B cells or plasma cells. Long-lived plasma cells persist and provide protection in the absence of antigen re-exposure for years. 7 The long-lived plasma cells that reside in the bone marrow are known to have heavily somatically mutated variable region genes and thus produce high-affinity antibodies, suggesting that affinitybased selection does play a prominent role in their production. Highest affinity GC B cells are preferentially selected to undergo plasma cell differentiation. Enhanced BCR signaling is one candidate, as this has been shown to trigger plasma cell differentiation. However, the enhanced provision of T-cell help to GC B cells also drives a burst of plasma cell production. In addition to CD40, other T cell–derived signals can affect plasma cell differentiation in vivo such as IL-21mediated signals. The differentiated plasma cells do not express BCR, thus are unable to sense antigens, but release antibody molecules constantly. The released high affinity antibody molecules provide immediate protection upon reinfection, resulting in neutralization and opsonization of antigens. Most of the GC-derived plasma cells migrate to the bone marrow or local mucosa-associated lymphoid tissues. The bone marrow niche supports plasma cell survival through cooperative survival signals from stroma-derived cytokines. Memory B cells are activated following reappearance of antigen. Contrary to plasma cells these cells express antigen receptor and only following antigen recognition start to proliferate and differentiate to plasma cells or create the next generation of memory cells. Memory cells can be generated from T cell-B cell interactions in a GC-independent manner, nonetheless, the majority of memory cells in wild-type mice responding to T-dependent antigens are likely to arise from the GC reaction. The presence of SHM in Ig genes is characteristic in these memory B cells, although memory cells are of lower affinity than plasma cells. Post-GC memory B cells are not as specific as high affinity plasma cells, but overall, affinity of the memory B cells increases in line with the GC response. As opposed to terminally differentiated plasma cells, it may be advantageous to maintain relatively low-affinity memory B cells to provide the flexibility to respond to variant pathogens that have mutated the initial target antigen. 4. Autoimmune reaction B cells that acquire reactivity with self-antigens are an undesirable but an inevitable product of the GC response and may be the basis of an autoantibody response. Because Ig SHM is a random process there is a continual risk to create or increase antibody affinity for self-antigens. The production of dangerous autoantibodies in the GC must be tightly controlled. Isolated cross-linking of the BCRs on GC B cells leads to rapid cell death in the absence of either FDC-associated cosignals or TFH help. GC B cells that preferentially interact with self-antigens in the GC will also be unable to access the co-signals associated with FDCs or TFH help. B cells that bind self-antigens 8 would not receive signal due to the absence of self-reactive T-cell help and due to the absence of self-antigens on the FCDs. Most of the autoreactive B cells either created during SHM or entering the GC from the circulation die by apoptosis in the absence of the aforementioned survival signals. There is the possibility however, that GC B cells undergo somatic mutations that increase their affinity for foreign antigen and in the meantime acquired them self-reactive BCRs , creating crossreactive specificities. Cross-reaction leads to the development of autoimmune B cells, especially when expression of the target self-antigen is either extremely low or absent from the GC, such as for a tissue-specific protein. In this case, recognition of FDC-associated foreign antigen and signals from foreign antigen specific TFH cells would also support these B cells resulting in their differentiation into plasma cells and the production of high-affinity antibodies directed against the original foreign antigen. However, once released into extracellular fluids, these same antibodies would also be free to access and bind the distal self-antigen targets, potentially contributing to an organ-specific autoimmune disease. Accordingly, high-affinity heavily mutated antibodies have been found in patients suffering different autoimmune diseases. In summary, even though the germinal center reactions are highly controlled by the balance of survival and apoptotic signals for B cells, somatic mutations highly increase the risk of autoimmune reactions. 9