B cell-activating factor an orchestrator of lymphoid follicles in severe chronic obstructive pulmonary disease

Francesca Polverino, Borja G. Cosio, Jaime Pons, Maria Laucho-Contreras, Paula Tejera, Amanda Iglesias, Angel Rios, Andreas Jahn, Jaume Sauleda, Miguel Divo, Victor Pinto-Plata, Lynette Sholl, Ivan O. Rosas, Alvar Agustí, Bartolome R. Celli, Caroline A. Owen

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Rationale: Patients with chronic obstructive pulmonary disease (COPD) have increased pulmonary lymphoid follicle (LF) counts. B cell-activating factor of tumor necrosis factor family (BAFF) regulates B cells in health, but its role in COPD pathogenesis is unclear. Objectives: To determine whether BAFF expression in pulmonary LFs correlates with COPD severity, LF size or number, and/or readouts of B-cell function in LFs. Methods: We correlated BAFF immunostaining in LFs in lung explants or biopsies from nonsmoking control subjects (NSC), smokers without COPD (SC), and patients with COPD with the number and size of LFs, and LF B-cell apoptosis, activation, and proliferation. We analyzed serum BAFF levels and BAFF expression in B cells in blood and bronchoalveolar lavage samples from the same subject groups. We assessed whether: (1) cigarette smoke extract (CSE) increases B-cell BAFF expression and (2) recombinant BAFF (rBAFF) rescues B cells from CSE-induced apoptosis by inhibiting activation of nuclear factor-kB (NF-kB). Measurements and Main Results: Patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage IV COPD had increased numbers and larger pulmonary LFs than patients with GOLD stages I-II COPD and SC. We identified two main types of pulmonary LFs: (1) type A, the predominant type in GOLD stages I-II COPD and SC, characterized by abundant apoptotic but few BAFF-positive cells (mostly B cells); and (2) type B, the main type in GOLD stage IV COPD, characterized by abundant BAFF-positive cells but few apoptotic cells (mostly B cells). BAFF levels were also higher in blood and bronchoalveolar lavage B cells in patients with COPD versus NSC and SC. Surprisingly, rBAFF blocked CSE-induced B-cell apoptosis by inhibiting CSE-induced NF-kB activation. Conclusions: Our data support the hypothesis that B-cell BAFF expression creates a self-perpetuating loop contributing to COPD progression by promoting pulmonary B-cell survival and LF expansion.

Original languageEnglish (US)
Pages (from-to)695-705
Number of pages11
JournalAmerican journal of respiratory and critical care medicine
Issue number6
StatePublished - Sep 15 2015
Externally publishedYes


  • Autoimmunity
  • B cell-activating factor of tumor necrosis factor family
  • Chronic obstructive pulmonary disease
  • Cigarette smoke
  • Lymphoid follicles

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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