title: Autologous stem cell transplantation for paediatric-onset polyarteritis nodosa: changes in autoimmune phenotype in the context of reduced diversity of the T- and B-cell repertoires, and evidence for reversion from the CD45RO(+) to RA(+) phenotype.
abstract: We have studied immune reconstitution in a patient with paediatric-onset polyarteritis nodosa treated with high-dose immunosuppressive agents followed by stem cell rescue. The patient developed several new autoimmune phenomena over the 18 months after immunosuppression and stem cell rescue. Flow cytometry, reverse transcription-polymerase chain reaction (RT-PCR) heteroduplex and isotype-specific RT-PCR analysis of immunoglobulin expression showed that the T- and B-cell repertoires were highly restricted in the first few months after treatment. The dominant T-cell clones seen after reconstitution were persistently expanded, were different from those which could be demonstrated before autologous stem cell transplantation, and were in the CD8(+) population. Our data also show that 12 months after treatment these expanded T-cell clones were within the CD45RA(+) population, suggesting that reversion from the CD45RO(+) to the CD45RA(+) phenotype had occurred in vivo.
authors.affiliation: Paediatric Rheumatology Unit, Institute of Child Health and Department of Molecular Pathology, University College London, London, UK.
authors.forename: L R
authors.initials: LR
authors.lastname: Wedderburn
authors.forename: R
authors.initials: R
authors.lastname: Jeffery
authors.forename: H
authors.initials: H
authors.lastname: White
authors.forename: A
authors.initials: A
authors.lastname: Patel
authors.forename: H
authors.initials: H
authors.lastname: Varsani
authors.forename: D
authors.initials: D
authors.lastname: Linch
authors.forename: K
authors.initials: K
authors.lastname: Murray
authors.forename: P
authors.initials: P
authors.lastname: Woo
mesh_terms: D000328:Adult; D017668:Age of Onset; D001402:B-Lymphocytes / Q000737:chemistry / Q000276:immunology*; D015415:Biomarkers; D005260:Female; D005434:Flow Cytometry; D015870:Gene Expression / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D020180:Heteroduplex Analysis; D006801:Humans; D007156:Immunologic Memory / Q000276:immunology; D007165:Immunosuppression Therapy; D017493:Leukocyte Common Antigens / Q000032:analysis / Q000235:genetics* / Q000276:immunology; D010641:Phenotype; D010488:Polyarteritis Nodosa / Q000235:genetics / Q000276:immunology* / Q000628:therapy*; D013601:T-Lymphocytes / Q000737:chemistry / Q000276:immunology*; D014182:Transplantation, Autologous
chemical_list: D015415:Biomarkers; D017493:Leukocyte Common Antigens