[PDF][PDF] Loss of Bcl-6-expressing T follicular helper cells and germinal centers in COVID-19

N Kaneko, HH Kuo, J Boucau, JR Farmer… - Cell, 2020 - cell.com
N Kaneko, HH Kuo, J Boucau, JR Farmer, H Allard-Chamard, VS Mahajan
Cell, 2020cell.com
Humoral responses in coronavirus disease 2019 (COVID-19) are often of limited durability,
as seen with other human coronavirus epidemics. To address the underlying etiology, we
examined post mortem thoracic lymph nodes and spleens in acute SARS-CoV-2 infection
and observed the absence of germinal centers and a striking reduction in Bcl-6+ germinal
center B cells but preservation of AID+ B cells. Absence of germinal centers correlated with
an early specific block in Bcl-6+ T FH cell differentiation together with an increase in T-bet+ T …
Summary
Humoral responses in coronavirus disease 2019 (COVID-19) are often of limited durability, as seen with other human coronavirus epidemics. To address the underlying etiology, we examined post mortem thoracic lymph nodes and spleens in acute SARS-CoV-2 infection and observed the absence of germinal centers and a striking reduction in Bcl-6+ germinal center B cells but preservation of AID+ B cells. Absence of germinal centers correlated with an early specific block in Bcl-6+ TFH cell differentiation together with an increase in T-bet+ TH1 cells and aberrant extra-follicular TNF-α accumulation. Parallel peripheral blood studies revealed loss of transitional and follicular B cells in severe disease and accumulation of SARS-CoV-2-specific "disease-related" B cell populations. These data identify defective Bcl-6+ TFH cell generation and dysregulated humoral immune induction early in COVID-19 disease, providing a mechanistic explanation for the limited durability of antibody responses in coronavirus infections, and suggest that achieving herd immunity through natural infection may be difficult.
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