Kumar, Naveen

Abstract Description Weakened germinal center responses by the aged immune system result in diminished immunity against pathogens and reduced efficacy of vaccines. Prolonged contacts between activated B cells and CD4+ T cells are crucial to germinal center formation and Tfh differentiation, but it is unclear how aging impacts the quality of this interaction. Peptide immunization confirmed that aged mice have decreased expansion of antigen-specific GC B cells and reduced antibody titers. Aging was associated with accumulated Tfh cells with reduced BCL6 and increased CD39. When activated in vitro by aged antigen-presenting cells, young CD4+ naïve T cells generated reduced numbers of activated cells with upregulated CD40L. To determine the contribution of cell-extrinsic influences on antigen-specific Tfh induction, young, antigen-specific B and CD4+ T cells were transferred into aged hosts prior to immunization. Transferred cells had reduced expansion and differentiation into germinal center B cell and Tfh and reduced antigen-specific antibody titers when compared to young hosts. Young CD4+ T cells transferred into aged hosts differentiated into Tfh cells with reduced PD-1 and BCL6, and increased CD39. Recent studies have focused on immune profiling of CD4 T cells in young and aged mice following immunization. These results highlight the role of the lymphoid microenvironment in modulating CD4+ T cell differentiation, which contributes to impaired initiation and maintenance of germinal centers. Funding Sources Research was supported by NIH/NIA R01 AG080037 and the Mayo Clinic Robert and Arlene Kogod Center on Aging Innovation Award UL1R002377 to J.L. Topic Categories Vaccines and Immunotherapy (VAC)

AbstractWeakened germinal center responses by the aged immune system result in diminished immunity against pathogens and reduced efficacy of vaccines. Prolonged contacts between activated B cells and CD4+ T cells are crucial to germinal center formation and T follicular helper cell (Tfh) differentiation, but it is unclear how aging impacts the quality of this interaction. Peptide immunization confirmed that aged mice have decreased expansion of antigen‐specific germinal center B cells and reduced antibody titers. Furthermore, aging was associated with accumulated Tfh cells, even in naïve mice. Despite increased numbers, aged Tfh had reduced expression of master transcription factor BCL6 and increased expression of the ectonucleotidase CD39. In vitro activation revealed that proliferative capacity was maintained in aged CD4+ T cells, but not the costimulatory molecule CD40L. When activated in vitro by aged antigen‐presenting cells, young CD4+ naïve T cells generated reduced numbers of activated cells with upregulated CD40L. To determine the contribution of cell‐extrinsic influences on antigen‐specific Tfh induction, young, antigen‐specific B and CD4+ T cells were adoptively transferred into aged hosts prior to peptide immunization. Transferred cells had reduced expansion and differentiation into germinal center B cell and Tfh and reduced antigen‐specific antibody titers when compared to young hosts. Young CD4+ T cells transferred aged hosts differentiated into Tfh cells with reduced PD‐1 and BCL6 expression, and increased CD39 expression, though they maintained their mitochondrial capacity. These results highlight the role of the lymphoid microenvironment in modulating CD4+ T cell differentiation, which contributes to impaired establishment and maintenance of germinal centers.

Herpes zoster ophthalmicus (HZO) with post-herpetic neuralgia (PHN) and giant cell arteritis (GCA) are two diseases more commonly seen in the elderly population. Each has potentially serious and preventable visual complications by differing mechanisms. Treatments for the two diseases differ. Antiviral medications are used in HZO and high-dose corticosteroids in GCA. These two entities could potentially coexist in the same patient, leading to a complicated diagnostic scenario where a potentially treatable disease could be overlooked. Here, we report a patient who was suffering from PHN following zoster ophthalmicus who developed GCA within a time frame suggesting a potential pathogenic association with the reactivation of latent varicella zoster virus (VZV). This association could be either direct with viral vessel infiltration leading to the arteritis or by an indirect dysimmune route. A pathophysiological association with VZV leading to the development of GCA is proposed.