Anaïs Jiménez-Reinoso, PhD, Ana V

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Human plasma C3 is essential for the development of memory B, but not T, lymphocytes  Anaïs Jiménez-Reinoso, PhD, Ana V. Marin, MSc, Marta Subias, PhD, Alberto López-Lera, PhD, Elena Román-Ortiz, MD, Kathryn Payne, BSc Hons, Cindy S. Ma, PhD, Giuseppina Arbore, PhD, Martin Kolev, PhD, Simon J. Freeley, PhD, Claudia Kemper, PhD, Stuart G. Tangye, PhD, Edgar Fernández-Malavé, PhD, Santiago Rodríguez de Córdoba, PhD, Margarita López-Trascasa, PhD, José R. Regueiro, PhD  Journal of Allergy and Clinical Immunology  Volume 141, Issue 3, Pages 1151-1154.e14 (March 2018) DOI: 10.1016/j.jaci.2017.09.037 Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 B-lymphocyte immunophenotype. A, B-cell subset frequencies compared with normal percentiles (n = 10 HCs + patients vs 12 HDs). Symbols as in Fig E1, B. B, B-cell subsets (mean + SD) of individuals below (patients) or above (HDs + HCs) the 40 mg/dL plasma C3 threshold (gray area in C). C, Correlation analysis (Pearson r) of B-cell subsets and plasma C3 levels. HC, Healthy carrier; HD, healthy donors; ns, nonsignificant. Solid lines are best-fit linear regressions; dashed lines are 95% CIs. ∗P < .05 and **P < .01. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 C3 detection in T-cell lines and plasma from C3-deficient patients. A, Left, Intracellular C3 fragments in single cell lines from donors above or below the 40 mg/dL plasma C3 threshold (flow cytometry). Data are mean ± SD of GEO-MFI relative to isotype controls (dashed lines). ns, Nonsignificant. Right, Extracellular C3 detection by Western blot (α chain) vs ELISA and nephelometry (mg/dL means or range) in plasma from primary (MS, missense and FS, frameshift) and secondary (MS) C3-deficient patients. B, Subcellular T-cell colocalization of C3 fragments with cis-Golgi (confocal microscopy ×60 using 1 C3a- and 2 iC3b/C3dg-specific mAb, scale bars 5 μm). C, Statistical analysis of C3 fragment colocalization with several subcellular compartments (mean + SD; only r > 0.5 [dashed horizontal lines] were considered; P < *.05, **.01, ***.001). Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Cohort of studied individuals. A, Pedigrees from the 6 families studied; mutations in C3 or CFI are shown below each family tree. Arrows indicate studied individuals (red for patients, black for HCs) in each family. B, All patients showed plasma C3 levels below 40 mg/dL (right), which was considered a threshold for further analyses. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 T-lymphocyte immunophenotype analysis. A, T-cell subset distribution compared with normal 5th, 50th, and 95th percentiles (boxes; n = 17 HDs). Each symbol represents an individual from a single experiment. B, Statistical analysis comparing T-cell subsets (mean + SD) of individuals below (patients) or above (HDs + HCs) the 40 mg/dL plasma C3 threshold. C, Correlation between T-cell subsets and plasma C3. ns, Nonsignificant; r, Pearson correlation coefficient. Solid lines are the best fit after linear regression; dashed lines are their 95% CIs. Gray areas mark the less than 40 mg/dL plasma C3 range. Symbols as in Fig E1, B. *P < .05. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Lymphocyte proliferation in response to different stimuli. A, Scatter dot plots of patients and HCs T (CD3+) and B-cell (CD19+) proliferation in response to the indicated stimuli measured as % CFSE− cells after 5 days compared with normal 5th, 50th, and 95th percentiles (boxes; n = 18 HDs). B, Statistical analysis comparing lymphocyte responses (mean + SD) of individuals below (patients) or above (HDs + HCs) the 40 mg/dL plasma C3 threshold. CFSE, Carboxyfluorescein succinimidyl ester; NA, nonactivated; ns, nonsignificant; PWM, pokeweed mitogen; SEE, Staphylococcal Enterotoxin E; SEB, Staphylococcal Enterotoxin B. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 A, Diagram of native C3 (top) and its fragments and plasma or vesicular enzymes involved, including the binding sites in C3a, iC3b, and C3dg of the indicated mAb (clones between parentheses). B, The mutations in plasma C3–deficient patients from Table E1 are shown in native C3. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E5 Intracellular C3 analysis in T-cell lines from plasma C3–deficient patients. A, Representative intracellular C3a, iC3b/C3dg, and CD46 or CD19 expression in T (left) and B (right) lymphoblastoid cell lines derived from the indicated primary or secondary plasma C3–deficient patients compared with isotype controls (gray histograms). B, Intracellular C3a expression using mAb 2991 in T-cell lines from primary plasma C3–deficient patients (C3.1.II:1 and C3.2.II:1) and an HD, after TCR activation for 36 hours, measured by confocal microscopy (magnification ×100). Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E6 Differential effects of primary deficiencies of B-cell coreceptor components or ligands in B-cell differentiation and antibody synthesis. BCR, B-cell receptor; DEF, deficiency. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E7 Impact of primary and secondary plasma C3 deficiencies due to LOF/GOF C3 and LOF CFI mutations in extracellular C3 activation. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E8 Subcellular accumulation of C3 fragments in vesicular traffic degradation compartments of primary C3–deficient T cells (right) compared with HD T cells (left), combining our results and previous data.6,E17 Red arrows identify biosynthetic-secretory pathways; blue arrows denote retrieval/recycling pathways; green arrows identify endocytic pathways. C3aR, C3a receptor; CTSL, cathepsin-L. Journal of Allergy and Clinical Immunology 2018 141, 1151-1154.e14DOI: (10.1016/j.jaci.2017.09.037) Copyright © 2017 American Academy of Allergy, Asthma & Immunology Terms and Conditions