Examining B-cell dynamics and responsiveness in different inflammatory milieus using an agent-based model

IntroductionB-cells are essential components of the immune system that neutralize infectious agents through the generation of antigen-specific antibodies and through the phagocytic functions of naive and memory B-cells. However, the B-cell response can become compromised by a variety of conditions that alter the overall inflammatory milieu, be that due to substantial, acute insults as seen in sepsis, or due to those that produce low-level, smoldering background inflammation such as diabetes, obesity, or advanced age. This B-cell dysfunction, mediated by the inflammatory cytokines Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-alpha), increases the susceptibility of late-stage sepsis patients to nosocomial infections and increases the incidence or severity of recurrent infections, such as SARS-CoV-2, in those with chronic conditions. We propose that modeling B-cell dynamics can aid the investigation of their responses to different levels and patterns of systemic inflammation.MethodsThe B-cell Immunity Agent-based Model (BCIABM) was developed by integrating knowledge regarding naive B-cells, short-lived plasma cells, long-lived plasma cells, memory B-cells, and regulatory B-cells, along with their various differentiation pathways and cytokines/mediators. The BCIABM was calibrated to reflect physiologic behaviors in response to: 1) mild antigen stimuli expected to result in immune sensitization through the generation of effective immune memory, and 2) severe antigen challenges representing the acute substantial inflammation seen during sepsis, previously documented in studies on B-cell behavior in septic patients. Once calibrated, the BCIABM was used to simulate the B-cell response to repeat antigen stimuli during states of low, chronic background inflammation, implemented as low background levels of IL-6 and TNF-alpha often seen in patients with conditions such as diabetes, obesity, or advanced age. The levels of immune responsiveness were evaluated and validated by comparing to a Veteran's Administration (VA) patient cohort with COVID-19 infection known to have a higher incidence of such comorbidities.ResultsThe BCIABM was successfully able to reproduce the expected appropriate development of immune memory to mild antigen exposure, as well as the immunoparalysis seen in septic patients. Simulation experiments then revealed significantly decreased B-cell responsiveness as levels of background chronic inflammation increased, reproducing the different COVID-19 infection data seen in a VA population.ConclusionThe BCIABM proved useful in dynamically representing known mechanisms of B-cell function and reproduced immune memory responses across a range of different antigen exposures and inflammatory statuses. These results elucidate previous studies demonstrating a similar negative correlation between the B-cell response and background inflammation by positing an established and conserved mechanism that explains B-cell dysfunction across a wide range of phenotypic presentations. In this work, we present a computational model of immune memory formation in B-cells, the phenomenon that allows a human being to develop immunity against pathogens they have previously encountered. The computational model was developed as an agent-based model, in which cells are represented individually and perform their cellular functions and actions in response to stimuli form the environment and other cells. We examine the process of immune memory formation in the context of sepsis, a highly inflammatory condition that can occur after serious injuries, diseases, or trauma. We then use this model to offer an explanation for recent findings discussing the impact of repeated COVID-19 infection; specifically, we note that the referenced study was performed in a relatively narrow population, those that sought care at a Veterans Affairs (VA) hospital, that would experience higher than normal levels of background inflammation. We use the model to demonstrate that this background inflammation can impair the process of memory formation in response to a COVID-19 infection and posit one explanation for increasing severity of reinfections in the VA population.