The Journal of Experimental Medicine
Translational Medicine Lupus Symposium
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Published 7 April 2003. doi:10.1084/jem.20022020
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© Rockefeller University Press, 0022-1007/2003/4/939 $5.00
The Journal of Experimental Medicine, Volume 197, Number 7, 939-945

Brief Definitive Report

 Human Immunoglobulin M Memory B Cells Controlling Streptococcus pneumoniae Infections Are Generated in the Spleen

Stephanie Kruetzmann1,5, M. Manuela Rosado2, Holger Weber1, Ulrich Germing3, Olivier Tournilhac4, Hans-Hartmut Peter5, Reinhard Berner6, Anke Peters6, Thomas Boehm1, Alessandro Plebani7, Isabella Quinti8 and Rita Carsetti2

1 Max-Planck Institute for Immunology, Department of Developmental Immunology, D-79108 Freiburg, Germany
2 Research Center Ospedale Bambino Gesù, 00165 Roma, Italy
3 Department of Hematology, Heinrich Heine University, D-40225 Düsseldorf, Germany
4 Fédération des Maladies Infectieuses, CHU Hotel Dieu, 63003 Clermont-Ferrand, France
5 Division of Rheumatology and Clinical Immunology, University Hospital, D-79106 Freiburg, Germany
6 University Children's Hospital, D-79106 Freiburg, Germany
7 Division of Pediatrics and Institute of Molecular Medicine "Angelo Nocivelli, " University of Brescia, 25123 Brescia, Italy
8 Department of Clinical Medicine, University of Rome "La Sapienza," 00165 Roma, Italy

Address correspondence to Rita Carsetti, Research Center Ospedale Bambino Gesù, Piazza S. Onofrio 4, 00165 Roma, Italy. Phone: 39-06-72596823; Fax: 39-06-72596822; E-mail: Rita.Carsetti{at}uniroma2.it

Splenectomized and asplenic patients have a high incidence of infections by encapsulated bacteria and do not respond to polysaccharide vaccines. To understand whether the absence of the spleen is associated with a defined B cell defect, we analyzed B cell subsets in the peripheral blood. We found that a population of B cells known as immunoglobulin (Ig)M memory is lacking in patients without spleen. The absence of IgM memory B cells correlates with an impaired immune response to encapsulated bacteria not only in splenectomized patients, but also in individuals with an intact spleen. We show that the physiological and transient predisposition to pneumococcal infections of young children (0–2 yr) is associated with the lack of circulating IgM memory B cells and of serum antipolysaccharide IgM. We also demonstrate that IgM memory B cells are undetectable in a fraction of patients with common variable immunodeficiency, who have recurrent and invasive infections by encapsulated bacteria. IgM memory B cells, therefore, require the spleen for their generation and/or survival and are responsible for the protection against encapsulated bacteria.

Key Words: B cells • asplenia • polysaccharide vaccines • Streptococcus pneumoniae • infants


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