Treatment-Induced BAFF Expression and B Cell Biology in Multiple Sclerosis

Although fingolimod and interferon-beta are two mechanistically different multiple sclerosis (MS) treatments, they both induce B cell activating factor (BAFF) and shift the B cell pool towards a regulatory phenotype. However, whether there is a shared mechanism between both treatments in how they influence the B cell compartment remains elusive. In this study, we collected a cross-sectional study population of 112 MS patients (41 untreated, 42 interferon-beta, 29 fingolimod) and determined B cell subsets, cell-surface and RNA expression of BAFF-receptor (BAFF-R) and transmembrane activator and cyclophilin ligand interactor (TACI) as well as plasma and/or RNA levels of BAFF, BAFF splice forms and interleukin-10 (IL-10) and -35 (IL-35). We added an in vitro B cell culture with four stimulus conditions (Medium, CpG, BAFF and CpG+BAFF) for untreated and interferon-beta treated patients including measurement of intracellular IL-10 levels. Our flow experiments showed that interferon-beta and fingolimod induced BAFF protein and mRNA expression (P <= 3.15 x 10(-4)) without disproportional change in the antagonizing splice form. Protein BAFF correlated with an increase in transitional B cells (P = 5.70 x 10(-6)), decrease in switched B cells (P = 3.29 x 10(-4)), and reduction in B cell-surface BAFF-R expression (P = 2.70 x 10(-10)), both on TACI-positive and -negative cells. TACI and BAFF-R RNA levels remained unaltered. RNA, plasma and in vitro experiments demonstrated that BAFF was not associated with increased IL-10 and IL-35 levels. In conclusion, treatment-induced BAFF correlates with a shift towards transitional B cells which are enriched for cells with an immunoregulatory function. However, BAFF does not directly influence the expression of the immunoregulatory cytokines IL-10 and IL-35. Furthermore, the post-translational mechanism of BAFF-induced BAFF-R cell surface loss was TACI-independent. These observations put the failure of pharmaceutical anti-BAFF strategies in perspective and provide insights for targeted B cell therapies.

Automated summary

The study indicates that both fingolimod and interferon-beta induce BAFF protein and mRNA expression, leading to a shift in the B cell pool towards a regulatory phenotype. Specifically, BAFF protein correlated with an increase in transitional B cells, decrease in switched B cells, and reduction in B cell-surface BAFF-R expression. However, BAFF does not directly influence the expression of immunoregulatory cytokines IL-10 and IL-35.