Defining Origins of Malignant B Cells
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Leukemia (2009) 23, 2075–2080 & 2009 Macmillan Publishers Limited All rights reserved 0887-6924/09 $32.00 www.nature.com/leu ORIGINAL ARTICLE Defining origins of malignant B cells: a new circulating normal human IgM þ D þ B-cell subset lacking CD27 expression and displaying somatically mutated IGHV genes as a relevant memory population N Weston-Bell1, M Townsend1, G Di Genova1, F Forconi2 and SS Sahota1 1Cancer Sciences Division, School of Medicine, University of Southampton, Southampton, UK and 2Sezione Ematologia e Trapianti, Universita` di Siena, Siena, Italy In probing the cell of origin in malignant B cells, an imprint of In normal B cells, a memory of antigen is imprinted somatic hypermutation (SHM) in immunoglobulin (Ig) variable (V) irreversibly by SHM in Ig V genes during T-cell-dependent region genes delineates antigen encounter, and identifying the encounter through germinal centers (GCs) in secondary lym- precise pathway generating SHM in the normal B-cell counterpart 1 becomes relevant. SHM remains the definitive memory imprint in phoid organs. Isotype class switch recombination can also normal human B cells, but CD27 expression also delineates occur in the GCs by deleting specified constant region coding memory. Recently, dye extrusion adenosine triphosphate-bind- sequences.1 Although both SHM and class switch recombina- ing transporter assays identified circulating isotype-switched tion have generally been regarded as markers of memory B cells, memory B cells that lacked CD27, yet exhibited low levels of SHM. a seminal finding was the identification of CD27 as an To extend findings, we report a pre-switched CD27Àve circulating apparently robust phenotypic marker able to discriminate memory B-cell population in normal blood using comparable 2 assays, and isolated CD19 þ IgM þ D þ CD27Àve cells (499% between human naive and memory B cells. The circulating þ purity) for the analysis of IGHV5/IGHV3-IGHM transcripts. Of ‘classical’ CD27 memory pool in that study was shown to these (n ¼ 334), B78% were germ line and naive B cell derived. comprise mutated IgM þ D þ , IgM þ DÀve and IgG þ or IgA þ Strikingly, 21.9% of the transcripts were mutated. They B cells.2 However, SHM can also occur through T-independent showed 3–5 mutations (13.5% of sequences) and 45 mutations mechanisms ectopically at non-GC sites,3 and this may impact (8.4% of sequences) per transcript. Accrual of mutations in a subset of CD19 þ IgM þ D þ CD27Àve cells define a new circulating crucially on deciphering a role for instance, for infection-related pre-switched memory B-cell pool, present in substantial antigens in clonal tumor origins. numbers in the population harboring naive B cells. These In malignant B cells, there are instances when the presence of CD19 þ IgM þ D þ CD27Àve memory B cells may have a distinct SHM is confounding, as it does not correlate with the expected lineage and function, and seem relevant to understanding origins classical memory phenotype. This is illustrated by hairy cell of malignant B cells, in particular those of hairy cell leukemia leukemia (HCL) cells that exhibit mutated IGHV genes but are cells, which display mutated V genes yet lack CD27 expression. CD27Àve.4,5 In addition, in IgM-expressing Waldenstrom’s Leukemia (2009) 23, 2075–2080; doi:10.1038/leu.2009.178; Àve published online 24 September 2009 macroglobulinemia, mutated tumor cells are seen in CD27 6,7 Keywords: CD27; normal B-cell memory; somatic hypermutation; fractions, and it has been proposed that origins of this disease hairy cell leukemia may be from ‘unusual’ memory B cells.6 Interestingly, more recent observations indicate that the normal human B-cell memory pool may as yet not be mapped fully. These studies have examined the association of CD27 expression as an absolute requirement in normal human Introduction memory B cells. Pivotal to the studies is an assay based on dye extrusion by the adenosine triphosphate-binding cassette Defining the cell of origin that causes B-cell tumors is a central subfamily B1 (ABCB1) transporter pump, which is functionally question in understanding the pathogenesis of malignant B cells. 8 restricted to naive B cells. When loaded with a suitable dye, Allied to this are questions of a role for antigen in selecting such ABCB1-positive naive B cells extrude the dye and retain a low a cell, what the nature of antigen might be and whether it is þ level of dye fluorescence, whereas CD27 memory B cells are presented in the context of T-cell help or through T-independent 8 pump negative and retain much higher levels of dye. Using this pathways. We have been addressing these questions by focusing þ Àve assay, a population of IgG but CD27 B cells could be on the analysis of immunoglobulin (Ig) variable (V) region genes identified as ABCB1-negative in normal human blood lympho- in malignant B cells, as these genes encode the antigen-binding Àve þ Àve cytes. A subset of this ABCB1 IgG CD27 population was domains of the surface Ig molecule and can reveal important þ þ indeed shown to be functionally comparable with IgG CD27 aspects of clonal history of the cell of origin. The most striking 8 þ Àve memory B cells. It is noteworthy that these IgG CD27 cells aspect is whether such a cell has undergone somatic hyper- were not initially examined for V gene mutations. However, two mutation (SHM) in response to antigen, then generating þ Àve parallel studies established that the new memory IgG CD27 questions of where SHM may have occurred and in response population indeed displayed SHM, but at a lower level than did to which stimuli. 9,10 classical switched memory B cells. A relevance for these IgG þ CD27Àve cells also emerged in B-cell disease, specifically Correspondence: Dr SS Sahota, Cancer Sciences Division, School of for systemic lupus erythematosus in which they represent a Medicine, Southampton University Hospitals, Tremona Road, South- major circulating compartment.10 ampton SO16 6YD, UK. E-mail: [email protected] As yet, however, it is not known whether a pre-switched Àve Received 23 December 2008; revised 3 July 2009; accepted 13 July CD27 component also exists in the normal human circula- 2009; published online 24 September 2009 tion, with a parallel mutational imprint. This is of relevance Human IgM þ D þ memory B cells lacking CD27 N Weston-Bell et al 2076 for understanding the CD27Àve memory B-cell pool more 5 mg/ml (Dako) and streptavidin-perCP-cy5.5 at 2 mg/ml (BD) at fully as well as for defining origins of B cells in malignancy. 4 1C for 30 min. Isotype antibody control labeling was In this study, we report the IGHV mutational status performed as described above. Separation of both ABCB1- of CD19 þ IgM þ D þ CD27Àve cells in normal circulating positive and ABCB1-negative cells was established using the B lymphocytes. ABCB1 transporter inhibitor. As MTG was never entirely extruded from cells, MTG-stained cells were spiked with unstained cells to confirm the correct acquisition voltage. Materials and methods CD19 þ IgM þ D þ cells were then analyzed by MTG retention and CD27 expression as reported.8 Analysis and isolation of circulating B lymphocytes by flow cytometry procedures Peripheral blood mononuclear cells were isolated from healthy Isolation of RNA and DNA for IGHV analysis donors after obtaining informed consent using Lymphoprep The highly purified CD19 þ IgD þ CD27Àve,CD19þ IgD þ CD27 þ (Axis Shield, Bicton Industrial Park, UK), and were analyzed and and CD19 þ IgDÀveCD27 þ populations were used for RNA cell sorted by flow cytometry using a FACSAria (BD Biosciences, extraction using the RNeasy Mini Kit (Qiagen, Crawley, UK), Oxford, UK). The two donors for cell sorted fractions for and cDNA was synthesized using SuperScript II Reverse molecular analysis were aged 23 and 36 years, respectively. Transcriptase (Invitrogen), both in accordance with the For flow cytometry, 2–4 Â 107 peripheral blood mononuclear manufacturers’ instructions. Using cDNA, IGHM transcripts cells were incubated with a-CD19-perCP-cy5.5 at 1:10 (BD were specifically amplified with downstream Cm primers. Pharmingen, Oxford, UK), a-IgM-phycoerythrin (PE) at 10 mg/ml IGHV5-IGHM gene transcripts were amplified from (Dako, Ely, UK), a-IgD-FITC (a-IgD-fluorescein isothiocyanate) sorted CD19 þ IgD þ CD27Àve, CD19 þ IgD þ CD27 þ and at 16 mg/ml (Dako) and a-CD27-allophycocyanin (APC) at 1:10 CD19 þ IgDÀveCD27 þ fractions by semi-nested reverse tran- (Biolegend, San Diego, CA, USA), or with relevant isotype scriptase-PCR, using in the first round a combination of IGHV5 antibody controls in FACS buffer (1% bovine serum albumin, leader (50-atggggtcaaccgccatcctcg) or IGHV3 leader (50-ccatg 4mM EDTA (ethylenediaminetetraacetic acid) and 0.15 mM gagtttgggctgagctgg) primers, respectively, with downstream sodium azide in phosphate-buffered saline) for 30 min at 4 1C. IGHM100 30 (50-ggagaaagtgatggagtcgg), followed in the second 0 Isotype antibody control labeling was performed with mIgG1,k- round of amplification by IGHV5 framework-1 (5 -gaggtg 0 perCP-cy5.5 (BD, Pharmingen), mIgG1,k-APC (BD, Pharmin- cagctgngtcagtctg) or IGHV3 framework-1 (5 -gaggtgcagctggtg 4,7,11 gen), rF(ab)2-FITC (Dako, Pharmingen) and rF(ab)2-PE (Dako) at sagtcyg) with IGHM100 as previously described. PCR equivalent concentrations to relevant staining antibody. Quad- products were cloned and individual plasmids with IGHV- rants defining positive and negative staining were positioned IGHM inserts were sequenced as described.4,7,11 Taq error was according to isotype control staining. calculated in a 350–400 bp stretch of the IGHM constant region Cells were gated first as lymphocytes by forward and side (excluding primer sequences) using semi-nested IGHV5 or scatter, and then CD19 þ IgM þ /Àve B cells were analyzed for IGHV3 upstream primers, as described above, with IGHM370 CD27 and IgD expression.