An efficient approach to study ANA⁺ B cells in autoimmune diseases integrating flow cytometry with single-cell analysis

OBJECTIVE: Several autoimmune diseases are characterized by the presence of autoantibodies to nuclear antigens. They are present in essentially all patients with systemic lupus erythematosus (SLE). The study of antinuclear antibodies (ANA) produced by individual B cells can offer critical insights into the structural and functional characteristics of autoantibodies. Conventional techniques of single-cell cloning and sequencing or single-cell (Nojima) cultures have significant limitations. To overcome these limitations, we developed an integrated platform that combines flow cytometric detection of ANA-reactive B cells with an optimized single-B cell culture system. METHODS: We employed a flow cytometry assay using biotinylated nuclear extracts and fluorochrome-tagged streptavidin to detect ANA-reactive B cells, followed by single cell sorting and culture in the presence of feeder cells expressing CD40L and BAFF, IL-2 and IL-21. This integrated approach was designed to enhance clonal resolution while increasing the efficiency of ANA-specific B cell recovery compared to conventional single-cell cloning methods. RESULTS: We isolated and expanded ANA + and ANA- B cells of various B cell subsets (naive, CD27 + IgM + , and IgG memory) that were isolated from healthy donors and patients with SLE. The cultures were maintained in standard conditions for 26 days at which time 82% of naïve, 53% of CD27 + IgM + and 64% of IgG⁺ memory B cells produced > 1.0 ug/mL of immunoglobulin. We further demonstrated that 88-95% of ANA + B cells Ig produced ANA-reactivity by HEp-2 staining. CONCLUSIONS: This method establishes a robust platform for isolating and expanding ANA B cells, facilitating the production of monoclonal autoantibodies and analysis of B cell receptor (BCR) gene sequences. This expansion is achieved by culturing single ANA + B cells with CD40L-expressing feeder cells and key cytokines (BAFF, IL-2, and IL-21) which together promote their survival, proliferation, and differentiation into antibody-secreting cells. The approach offers important new potential in understanding the etiology of ANA- reactive IgG in autoimmune disease by enabling the identification of specific autoantigen targets at distinct stages of B cell differentiation.