Characterization of T-cell repertoire of the bone marrow in immune-mediated aplastic anemia: evidence for the involvement of antigen-driven T-cell response in cyclosporine-dependent aplastic anemia.
To determine whether the antigen-driven T-cell response is involved in the pathogenesis of aplastic anemia (AA), we examined the complementarity-determining region 3 (CDR3) size distribution of T-cell receptor (TCR) beta-chain (BV) subfamilies in the bone marrow (BM) of untreated AA patients. AA patients who did not respond to immunosuppressive therapy and those who obtained unmaintained remission early after cyclosporine (CyA) or antithymocyte globulin (ATG) therapy exhibited essentially a normal CDR3 size pattern. In contrast, five patients who needed continuous administration of CyA to maintain remission exhibited a skewed CDR3 size pattern in a number (>40%) of BV subfamilies suggestive of clonal predominance. The skewing of CDR3 size distribution became less pronounced in one of the CyA-dependent patients when the patient achieved unmaintained remission after a 4-year therapy with CyA, whereas it persisted longer than 7 years in the other patient requiring maintenance therapy. Sequencing of BV15 cDNA for which the CDR3 size pattern exhibited apparent clonal predominance in all CyA-dependent patients showed high homology of the amino acid sequence of the CDR3 between two different patients. These findings indicate that antigen-driven expansion of T cells is involved in the pathogenesis of AA characterized by CyA-dependent recovery of hematopoiesis.
Zeng
W
W
Third Department of Medicine, the Department of Pediatrics, and Blood Transfusion Section, Kanazawa University School of Medicine, Kanazawa, Japan.
Nakao
S
S
Takamatsu
H
H
Yachie
A
A
Takami
A
A
Kondo
Y
Y
Sugimori
N
N
Yamazaki
H
H
Miura
Y
Y
Shiobara
S
S
Matsuda
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D000741:Anemia, Aplastic / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D001854:Bone Marrow Cells / Q000276:immunology* / Q000473:pathology; D003001:Cloning, Molecular; D022801:Complementarity Determining Regions; D016572:Cyclosporine / Q000627:therapeutic use*; D017931:DNA Primers; D005260:Female; D019674:Genes, T-Cell Receptor beta; D006801:Humans; D007137:Immunoglobulin alpha-Chains / Q000737:chemistry / Q000235:genetics; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D018807:Polymorphism, Single-Stranded Conformational; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000737:chemistry / Q000235:genetics / Q000276:immunology*; D012016:Reference Values; D016176:T-Lymphocyte Subsets / Q000276:immunology* / Q000473:pathology
D000961:Antilymphocyte Serum; D022801:Complementarity Determining Regions; D017931:DNA Primers; D007137:Immunoglobulin alpha-Chains; D007166:Immunosuppressive Agents; D016693:Receptors, Antigen, T-Cell, alpha-beta; D016572:Cyclosporine