Introduction
Most mature B cells require the B cell activating factor of the TNF family (BAFF) and its receptor BAFFR to survive [
1]. Different from other TNF receptor family members, BAFFR has a single extracellular cysteine-rich domain (CRD) [
2] that is needed for the pre-assembly into multimers as well as for ligand binding [
3]. When BAFF binds to BAFFR, it activates the non-canonical nuclear factor kappa B (NF-κB2) pathway [
4,
5], which is a slow process as it requires the de novo synthesis and accumulation of NIK [
6]. NF-κB2 activity then upregulates anti-apoptotic genes that support the survival of peripheral B cells [
7‐
10]. BAFFR also activates the phosphoinositide-3 kinase (PI3K) and extracellular signal regulated kinases (ERK), which coordinately control B cell survival, metabolic responses, and cellular fitness [
8,
9,
11‐
15].
In mice, the inactivation of
Baffr [
16] or
Baff [
17] blocks B cell development beyond the stage of transitional B cells reducing drastically the number of follicular and marginal zone B cells. In humans, complete BAFFR deficiency has been found by screening patients with common variable immunodeficiency (CVID). The homozygous deletion removed part of the BAFFR transmembrane (TM) region and resulted in severe B lymphopenia, the loss of marginal zone and switched memory B cells, low serum immunoglobulin M (IgM) and IgG levels, and strongly impaired T cell-independent B cell responses [
18].
In addition to this deletion, several single nucleotide variants (SNVs) in the
BAFFR gene (
TNFSRF13C) have been reported in CVID patients [
3,
19‐
21]. A guanine to cytosine exchange in exon 1 (c.62C > G, rs77874543) results in the amino acid substitution of proline21 by arginine (P21R) and occurs with an allele frequency in the general population of approximately 8%. Pro21 is completely conserved in primates and resides in a loop of CDR1 close to the BAFF binding site that forms the pre-ligand assembly domain (PLAD) of BAFFR. Therefore, the change of Pro21 to Arg21 disturbs ligand-independent and ligand-enhanced multimerization of BAFFR [
3].
The guanine-191-to-thymine (c.191G > T, rs547352394) exchange has been described first in CVID [
19]. It has an allele frequency of 1.5% and substitutes within a highly conserved region of the extracellular domain glycine for valine at position 64 (G64V).
The rs151243201 (c.43C > T, p.P146S) variant is encoded by exon 3. It has a highly variable allele frequency of 1/395 in African/African American population compared to < 1/128,530 alleles in European non-Finnish population and affects an evolutionary well-conserved proline-rich motif (PxWPP) in the intracellular domain.
The H159Y variant (c.475C > T, rs1756766) changes His159 against Tyr affecting a region that is conserved between birds and mammals, as it is directly adjacent to the TNF receptor-associated factor (TRAF3) recognition motif PVPAT. The H159Y variant results in a hyperactive receptor with enhanced recruitment of TRAF3 and TRAF6 [
20,
22]. H159Y has an increased prevalence in patients suffering from Sjögren’s syndrome-related lymphoma, non-Hodgkin lymphoma, and multiple sclerosis [
20,
22,
23]. H159Y and P21R were found to co-segregate [
21,
23] suggesting that this allelic combination had a selective advantage.
Apart from these known BAFFR variants, we evaluate here two novel BAFFR variants detected in individuals with CVID. The first variant that been discovered in a CVID patient results from a guanine-154-to-adenine (c.154G > A) exchange substituting a highly conserved alanine with threonine at position 52 (A52T). The rs776259962 SNP is an extremely rare allele and results in the duplication of four evolutionary conserved amino acids (LALV) ranging from position 92 to 95 in the TM region (DUP92-95).
Thus far, it remained unclear to which extent these BAFFR variants affect B cell survival and if they could contribute to disease development. To gain further insight into the causal relation between the BAFFR variants and their impact on BAFFR function and activity, we expressed these variants in the human Burkitt’s lymphoma cell line DG-75 and analyzed BAFFR oligomerization, BAFFR processing, and the activation of downstream signaling pathways. Our findings reveal that the variants affect functional properties of BAFFR and may contribute as modifying factors to an increased risk of developing primary immunodeficiency, autoimmunity, or B lymphomagenesis.
Discussion
The
BAFFR variants P21R, G64V, and H159Y have been described in patients with common variable immunodeficiency [
19]. Since BAFFR activates pro-survival functions, it has been proposed that these variants contribute to the development of CVID and antibody deficiencies [
36], lymphoma [
22,
37,
38], or autoimmune diseases [
23,
39]. In addition to these variants, we also describe here two variants—A52T and DUP92-95—that were newly found in CVID patients.
Except for P21R and H159Y, it has remained unclear to which extent such BAFFR variants change BAFFR function and if they correlate with or contribute to CVID. In our approach, we analyzed their allelic frequencies in CVID patients and studied their impacts on BAFFR function in a cellular model, which is based on the expression of the variants in the Burkitt’s lymphoma cell line DG-75.
By a functional step-by-step analysis, we first tested if the variants differ in binding to BAFF. Since BAFFR assembles spontaneously into homo-oligomers [
3], we then analyzed if the variants interfere with ligand-independent oligomerization. Binding of BAFF to BAFFR crosslinks BAFFR oligomers and initiates BAFFR signaling [
3,
27]. We therefore examined changes in BAFF-dependent BAFFR clustering as well as the activation of NF-κB, PI3K/AKT, and ERK1/2 signaling pathways. Since BAFF-induced activation of PI3K/AKT and of ERK1/2 involves components of the B cell antigen receptor [
33], we analyzed if the variants would affect interactions between BAFFR and CD79B. BAFF binding to BAFFR does not only induce BAFFR signaling, but it also activates the shedding of the BAFFR ectodomain by ADAM10/17 proteases [
35]. We therefore tested if the variants would impair BAFFR processing.
Of all variants, only the P21R missense mutation impaired all functions—binding of BAFF, ligand-independent and ligand-induced oligomerization, ectodomain shedding, recruitment of TRAF3 and activation of NF-κB2, interactions with CD79B and activation of AKT and ERK1/2 signaling. The P21 residue lies within the pre-ligand assembly domain [
3], which forms together with the ligand binding domain the single CRD of BAFFR. According to its 3D structure [
40], the PLAD points away from the ligand binding loop, and therefore, P21R is unlikely to interfere directly with BAFF binding. But because ligand-independent oligomerization greatly enhances ligand binding [
3], this variant also affects BAFF-induced downstream activation of NF-κB2, ERK1/2, and PI3K/AKT. This impairment of BAFFR functions is reflected by the significant association of the P21R encoding SNP rs77874543 with CVID (
P = 0.0145 – 0.0458). Since rs77874543 has an allele frequency of 8.6% in the general population, it remains an open question, why it is found with this high frequency in spite it affects BAFFR responses even in the heterozygous situation when co-expressed with WT BAFF. One explanation would be that P21R affects B cell responses not enough to cause a selective disadvantage, but at least for T-independent B cell activation this seems not to be the case [
3]. Alternatively, P21R could dampen overshooting or autoimmune B cell responses, which—as shown in the course of SARS-CoV-2 infections—can enhance infection [
41] and account for > 20% of deaths in certain populations ([
42,
43].
The P21R encoding rs77874543 co-segregates 10–15 × more frequently than expected with rs61756766 encoding H159Y. H159Y increases TRAF recruitment as well as activation of NF-κB2, which correlates positively with the development of lymphoma and autoimmunity [
20,
22,
23]. Our experiments show that H159Y functions like WT BAFFR except for the enhanced TRAF3 recruitment and NF-κB2 activation. The combination of P21R and H159Y displayed features of both variants: impaired BAFF binding, ligand-independent as well as BAFF-induced oligomerization, BAFFR processing, interaction with CD79B and AKT phosphorylation like P21R, but normal TRAF3 recruitment, NF-κB2 activation, and ERK1/2 phosphorylation like H159Y. Different from P21R, co-expression of WT BAFFR increased BAFF-induced clustering of P21R-H159Y suggesting that in a heterozygous situation, B cells of P21R-H159Y carriers would respond normally to BAFF-induced activation. This assumption correlates with the frequency for P21R-H159Y in CVID patients which does not differ significantly from the control population (
P = 0.8233). Thus, the linkage disequilibrium observed for P21R-H1159Y could reflect a selective advantage of rs77874543 (P21R) carriers who have acquired the H159Y mutation because the mutation would balance some of the defects of P21R and allow close to normal B cell responses.
G64V and A52T reside in the loop from Leu37-Leu71 connecting the CRD to the TM region, which is affected by DUP92-95. A52T slightly reduced BAFF binding, both G64V and A52T disturbed ligand-independent but not ligand-dependent BAFFR oligomerization, and all three variants interfered with ligand-independent as well as ligand-dependent interactions between BAFFR and CD79B. Weaker interactions of A52T, G64V, and DUP92-95 with CD79B correlate with impaired phosphorylation of AKT and, in the case of G64V and DUP92-95, also with reduced phosphorylation of ERK1/2 in BAFF-activated cells. Thus, the loop region Leu37-Leu71 as well as the TM region could be involved in contacts between BAFFR and CD79B. CD79B forms a heterodimer with CD79A and both interact closely with the heavy chains of surface immunoglobulins through their extracellular parts and transmembrane domains [
44‐
48]. The TM region of BAFFR contains several leucines which could form two leucine zippers located on opposite sites of the TM α-helix. These zippers could provide the interfaces for the contacts in between TM regions of BAFFR chains as well as with the TM region of CD79B. The DUP92-95 reduces the leucin zipper L(X)
6L repeats within the TM region from four to three. Since the duplication does not change ligand-independent BAFFR oligomerization, this part of the BAFFR TM region could be the side of the TM region involved in ligand-independent contacts with CD79B.
The G64V encoding rs547352394 allele was so far found in CVID patients in a heterozygous form. Since the co-expression of G64V with WT BAFFR restored ligand-independent oligomerization, the cellular model predicts that in a heterozygous situation B cells of G64V carriers respond normally to BAFF. This was supported by normal phosphorylation of
S6 in BAFF-activated B cells from a heterozygous G64V carrier, reflecting the finding that rs547352394 does not associate with CVID.
A52T was found so far not in the general population and only once in a heterozygous form in a CVID patient who was treated with rituximab because of severe autoimmune cytopenia. A52T reduced BAFF binding to 83% of WT BAFFR levels and impaired ligand-independent BAFFR oligomerization, interactions with CD79B, and phosphorylation of AKT and ERK1/2. Therefore, it seems unlikely that this variant was responsible for the development of autoimmunity in this patient because autoimmunity would be expected to correlate with increased and not with reduced B cell functions.
DUP92-95 was found only in one CVID patient and was inherited from the unaffected mother indicating its incomplete penetrance. However, B cells of both individuals did not respond to BAFF by phosphorylating
S6, and in the DG-75 model system, the DUP92-95 variant also impaired AKT and ERK1/2 phosphorylation. Since DUP92-95 disturbed ligand-independent and ligand-dependent interactions between BAFFR and CD79B, the TM region seems to form an interface between BAFFR and CD79B that allows BAFFR to fully activate PI3K signaling via the BCR component. As it was found only once in a CVID patient and because the corresponding SNP rs776259962 is very rare (1/234974), we cannot conclude if this variant associates with CVID.
P146S has not yet been discovered in CVID patients. The variant affects the first proline of a highly conserved proline-rich motif (WPPPG) within the intracellular region of BAFFR. After P21R (8.67% allele frequency), G64V (0.9%), H159Y (0.75%), and R106Q (0.15%), P146S is the fourth most common BAFFR variant. It affected activation of NF-κB2 and ligand-independent BAFFR oligomerization as seen by the reduced percentage of FRET+ cells. Lower percentages of FRET+ cells could be result from structural changes of the cytoplasmic tail which would increase the distance between the GFP and RFP parts of the fusion proteins, while reduced activation NF-κB2 could reflect TRAF3 recruitment that remained undetected by the BAFFR-TRAF3 co-immunoprecipitation experiments.
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