B cells, antibody-secreting cells and virus-specific antibodies respond to herpes simplex virus-2 reactivation in skin.

Tissue-based T cells are important effectors in the prevention and control of mucosal viral infections – less is known about tissue-based B cells. We demonstrate that B cells and antibody-secreting cells (ASCs) are present in inflammatory infiltrates in skin biopsies of persons during symptomatic HSV2 reactivation and early healing. Both CD20+ B cells, most of which are antigen-inexperienced by co-expression of IgD, and ASCs, characterized by dense IgG RNA expression in combination with CD138, IRF4 and Blimp1 RNA, are seen in association with T cells. ASCs are found clustered with CD4+ T cells, suggesting potential for crosstalk. HSV2-specific antibodies to virus surface antigens are also present in tissue and increase in concentration during HSV2 reactivation and healing, unlike in serum where concentrations remain static over time. B cells, ASCs, and HSV-specific antibody were rarely detected in biopsies of unaffected skin. Evaluation of serial biopsies demonstrate that B cells and ASCs follow a more migratory than resident pattern of infiltration in HSV-affected genital skin, in contrast to T cells. Together, these observations suggest distinct phenotypes of B cells in HSV-affected tissue; dissecting their role in reactivation may reveal new therapeutic avenues to control these infections.