Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19
Naoki Kaneko 8
Hsiao-Hsuan Kuo 8
Julie Boucau 8
Robert F. Padera Jr.
Shiv Pillai 9
the Massachusetts Consortium on Pathogen Readiness Specimen Working Group
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Published:August 19, 2020DOI:https://doi.org/10.1016/j.cell.2020.08.025
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.
