title: Skewed T-cell receptor variable gene usage in the synovium of early and chronic rheumatoid arthritis patients and persistence of clonally expanded T cells in a chronic patient.
abstract: OBJECTIVE
  Autoreactive T cells may contribute to the pathogenesis of rheumatoid arthritis (RA). We studied the T-cell receptor (TCR) V-gene repertoire in the blood and synovium of early and chronic RA patients using polymerase chain reaction-enzyme-linked immunosorbent assay to evaluate possible differences between these patient groups.
  
  
  RESULTS
  Over-represented TCR V genes were observed in the synovium, but not in the blood of all RA patients (n = 38). The number of over-represented V genes was higher in the synovium of chronic RA patients (n = 31) than in that of early RA patients (n = 7). The V-gene profile was different among patients, and similar in the two knees for patients with bilateral synovitis (n = 5). The clonal composition of over-represented TCR BV genes in a patient with early RA and a patient with chronic RA was further studied by CDR3 region sequence analysis. A high level of clonal diversity was found in the joints and the blood of the early RA patient, suggesting a polyclonal T-cell expansion. In the chronic RA patient, predominant clonal expansions were observed in the blood and synovium, and some expanded clones were still present 2 yr later.
  
  
  CONCLUSIONS
  The observation of similar T-cell populations in both joints in patients with bilateral synovitis and the persistence of clonally expanded T cells for more than 2 yr in the joints of a chronic RA patient may indicate a pathogenic role for these cells in the disease process.
authors.affiliation: Biomedisch Onderzoeksinstituut DWI, Limburgs Universitair Centrum, Diepenbeek, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: VanderBorght
authors.forename: P
authors.initials: P
authors.lastname: Geusens
authors.forename: C
authors.initials: C
authors.lastname: Vandevyver
authors.forename: J
authors.initials: J
authors.lastname: Raus
authors.forename: P
authors.initials: P
authors.lastname: Stinissen
mesh_terms: D000595:Amino Acid Sequence; D001172:Arthritis, Rheumatoid / Q000235:genetics* / Q000276:immunology* / Q000473:pathology; D001324:Autoantigens / Q000235:genetics / Q000276:immunology; D002908:Chronic Disease; D003001:Cloning, Molecular; D022801:Complementarity Determining Regions / Q000097:blood / Q000235:genetics* / Q000276:immunology; D015870:Gene Expression / Q000276:immunology; D006801:Humans; D007719:Knee Joint / Q000276:immunology / Q000473:pathology; D008969:Molecular Sequence Data; D011948:Receptors, Antigen, T-Cell / Q000235:genetics* / Q000276:immunology; D013582:Synovial Fluid / Q000276:immunology; D013583:Synovial Membrane / Q000276:immunology* / Q000473:pathology
chemical_list: D001324:Autoantigens; D022801:Complementarity Determining Regions; D011948:Receptors, Antigen, T-Cell