The following is a summary of “IgA+ memory B-cells are significantly increased in patients with asthma and small airway dysfunction” published in the November 2022 issue of Respiratory by Habener et al.

In-depth research into T-cells’ part in asthma led to individualized therapeutic options for managing severe eosinophilic asthma. B-cells may have a role in this chronic inflammatory condition, but little is known. In this investigation, researchers aimed to determine whether or whether distinct B-cell subsets were responsible for observed associations between asthmatic phenotypes. A total of 154 adults with asthma and 28 healthy controls were included in the ALLIANCE cohort to have their B-cells characterized by flow cytometry. Data on B-cells were combined with information gathered from questionnaires, lung function tests, blood differential counts, and allergy testing to form a thorough analysis.

Immature B-cell populations were lower in patients with severe asthma, whereas memory B-cells were considerably higher in patients with severe asthma compared to patients with mild to moderate asthma and healthy controls. In addition, measures indicating enhanced resistance in the peripheral airways were linked to decreased lung function and higher frequencies of IgA+ memory B-cells. As a result, patients with mild-to-moderate asthma and small airway dysfunction (SAD) as characterized by impulse oscillometry had higher frequencies of IgA+ memory B-cells. 

Exacerbations and other clinical characteristics of SAD were also substantially linked with IgA+  memory B-cells. In this study, researchers show for the first time that elevated levels of IgA+ memory B-cells are linked to both asthma and SAD, suggesting that B-cell-directed techniques may one day be used to better manage the disease.