Advances in the management of malignant pleural effusion

Activated naïve B cells promote development of malignant pleural effusion by differential regulation of TH1 and TH17 response

Inflammatory signaling networks between tumor cells and immune cells contribute to the development of malignant pleural effusion (MPE). B cells have been found in MPE; however, little is known about their roles there. In the present study, by using mouse MPE models, we noted that although the total B cells in MPE were decreased as compared with the corresponding blood and spleen, the percentage of activated naïve B cells expressing higher levels of CD80, CD86, myosin heavy chain-II, CD44, CD69, and programmed cell death-ligand 1 (PD-L1) molecules were increased in wild-type mouse MPE. Compared with wild-type mice, decreased T helper (T_H)1 cells and increased T_H17 cells were present in B cell-deficient mouse MPE, which paralleled to the reduced MPE volume and longer survival time. Adoptive transfer of activated naïve B cells into B cell-deficient mice was able to increase T_H1 cells and decrease T_H17 cells in MPE and shorten the survival of mice bearing MPE. Furthermore, we demonstrated that activated naïve B cells inhibited T_H17-cell expansion via the PD-1/PD-L1 pathway and promoted naïve CD4⁺ T-cell differentiation into T_H1/T_H17 cells through secreting IL-27/IL-6 independent of the PD-1/PD-L1 pathway. Collectively, our data uncovered a mechanism by which naïve B cells promote MPE formation by regulating T_H1/T_H17 cell responses, making these B cells an attractive target for therapeutic intervention in the fight against cancer.