Extended B cell phenotype in patients with myalgic encephalomyelitis/chronic fatigue syndrome: a cross-sectional study. (22nd February 2016)

• Record Type: Journal Article
• Authors: Mensah, F; Bansal, A; Berkovitz, S; Sharma, A; Reddy, V; Leandro, M J; Cambridge, G
• Is Part Of: Clinical and experimental immunology. Volume 184:Number 2(2016:May)
• Page Start: 237
• Page End: 247
• Publication Date: 2016-02-22
• Subjects: B cells -- chronic fatigue syndrome -- flow cytometry -- human -- myalgic encephalomyelitis; Immunopathology -- Periodicals; 616.079
• DOI: 10.1111/cei.12749
• Languages: English
• ISSNs: 0009-9104

Abstract

Summary: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a heterogeneous condition of unknown aetiology characterized by multiple symptoms including fatigue, post-exertional malaise and cognitive impairment, lasting for at least 6 months. Recently, two clinical trials of B cell depletion therapy with rituximab (anti-CD20) reported convincing improvement in symptoms. A possible but undefined role for B cells has therefore been proposed. Studies of the relative percentages of B cell subsets in patients with ME/CFS have not revealed any reproducible differences from healthy controls (HC). In order to explore whether more subtle alterations in B cell subsets related to B cell differentiation exist in ME/CFS patients we used flow cytometry to immunophenotype CD19 + B cells. The panel utilized immunoglobulin (Ig)D, CD27 and CD38 (classical B cell subsets) together with additional markers. A total of 38 patients fulfilling Canadian, Centre for Disease Control and Fukuda ME/CFS criteria and 32 age- and sex-matched HC were included. We found no difference in percentages of classical subsets between ME/CFS patients and HC. However, we observed an increase in frequency ( P < 0·01) and expression (MFI; P = 0·03) of CD24 on total B cells, confined to IgD + subsets. Within memory subsets, a higher frequency of CD21 + CD38 – B cells (>20%) was associated with the presence of ME/CFS [odds ratio: 3·47 (1·15–10·46); P = 0·03] compared with HC, and there was a negative correlation with disease duration. In conclusion, we identified possible changes in B cell phenotype in patients with ME/CFS. These may reflect altered B cell function and, if confirmed in other patient cohorts, could provide a platform for studies based on clinical course or responsiveness to rituximab therapy.