Understanding The Role Of Antibody Producing B Cells In Transverse Myelitis

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Ligocki et al. published a study in 2013 that discussed plasmablasts that have been found in a certain subset of transverse myelitis patients. Plasmablasts are white blood cells (B cells) that secrete antibodies. The authors looked at the cerebrospinal fluid (CSF) and peripheral blood of 33 patients with clinically isolated syndrome (CIS), which included 11 patients with optic neuritis (ON) and 22 with transverse myelitis (TM). Those diagnosed with CIS have a high risk of eventually being diagnosed with multiple sclerosis (MS), especially if brain lesions are present on MRI. Also, ON patients tend to have a better long-term prognosis than TM patients if they are eventually diagnosed with MS. Because of this difference in prognosis, Ligocki et al. hypothesized that TM patients would have a high expression of what are known as CD27 B cells (B cells with a unique marker known as CD27) in their CSF and peripheral blood. High expression of CD27 cells is seen in several autoimmune diseases, including neuromyelitis optica and rheumatoid arthritis.

The authors looked at the B cells in the CSF and blood of the 33 CIS patients and found that overall, B cell/plasma cell percentages and numbers were similar between those with ON and those with TM, but there was a group of TM patients who had high expression of CD27 cells in both their CSF and blood compared to ON patients. They also found a correlation between finding CD27 cells in the peripheral blood of this subset and the length of time they were not treated for transverse myelitis. Overall, 41% (9/22) TM patients had high levels of CD27 in their CSF, and 45% (10/22) had high levels of CD27 in their peripheral blood. The authors note that the presence of CD27 cells may influence disease progression and severity in those with TM.

Original research: A J Ligocki, W H Rounds, E M Cameron, C T Harp, E M Frohman, A M Courtney, S Vernino, L G Cowell, B Greenberg and N L Monson. Expansion of CD27high plasmablasts in transverse myelitis patients that utilize VH4 and JH6 genes and undergo extensive somatic hypermutation. Genes Immun. 2013;14(5):291-301.