Primary biliary cirrhosis (PBC) is a chronic and slowly progressive cholestatic
liver disease of autoimmune etiology. A number of questions regarding its
etiology are unclear. CD4+CD25+ regulatory T cells (Tregs) play a
critical role in self-tolerance and, for unknown reasons, their relative number
is reduced in PBC patients. B-cell-activating factor (BAFF) is a key survival
factor during B-cell maturation and its concentration is increased in peripheral
blood of PBC patients. It has been reported that activated B cells inhibit Treg
cell proliferation and there are no BAFF receptors on Tregs. Therefore, we
speculated that excessive BAFF may result in Treg reduction via B cells. To
prove our hypothesis, we isolated Tregs and B cells from PBC and healthy donors.
BAFF and IgM concentrations were then analyzed by ELISA and CD40, CD80, CD86,
IL-10, and TGF-β expression in B cells and Tregs were measured by flow
cytometry. BAFF up-regulated CD40, CD80, CD86, and IgM expression in B cells.
However, BAFF had no direct effect on Treg cell apoptosis and cytokine
secretion. Nonetheless, we observed that BAFF-activated B cells could induce
Treg cell apoptosis and reduce IL-10 and TGF-β expression. We also showed
that BAFF-activated CD4+ T cells had no effect on Treg apoptosis.
Furthermore, we verified that bezafibrate, a hypolipidemic drug, can inhibit
BAFF-induced Treg cell apoptosis. In conclusion, BAFF promotes Treg cell
apoptosis and inhibits cytokine production by activating B cells in PBC
patients. The results of this study suggest that inhibition of BAFF activation
is a strategy for PBC treatment.