gammadelta T cell subsets in patients with arthritis and chronic neutropenia.
BACKGROUND
An abnormal distribution of subsets of gammadelta T cells, which are a component of the inflammatory infiltrate in arthritic synovium, has been demonstrated in the peripheral blood (PB) of patients with arthritis and neutropenia.


OBJECTIVE
To evaluate whether the clinical manifestations of patients with arthritis and neutropenia are related to the specific gammadelta T cell subset predominant in the PB.


METHODS
Flow cytometry of PB lymphocytes in six consecutive patients with chronic neutropenia and arthritis was performed. Variable (V) gamma and delta gene families were analysed by polymerase chain reaction. cDNA was subjected to direct automated sequencing of T cell receptor (TCR) genes.


RESULTS
Three patients had non-deforming and non-erosive rheumatoid factor (RF)(+) polyarticular rheumatoid arthritis, RF(+) oligoarticular arthritis, or RF(-) non-deforming oligoarticular psoriatic arthritis with persistent expansions of Vgamma1(+)/Vdelta2(+), Vgamma2(+)/Vdelta2(+), or Vgamma1(+)/Vdelta (undetermined (2- 1-)) T cells, respectively. The other three patients, without persistent expansion of gammadelta T cells, had either non-deforming and non-erosive oligo- or polyarthritis with a balanced distribution of several Vdelta and Vgamma genes, or severe erosive RF(+) arthritis with deficiency of all but Vgamma1(+)/Vdelta1(+) T cells.


CONCLUSIONS
gammadelta T cell lymphoproliferations in chronic neutropenia and arthritis use different Vgamma and Vdelta gene families, often forming T cell receptor (TCR) structures that are infrequent in normal adult PB. Arthritis with Vgamma1(+)/Vdelta2(+), Vgamma2(+)/Vdelta2(+), or Vgamma1(+)/Vdelta2(-)/Vdelta1(-) gammadelta T cells in the PB is non-deforming and non-erosive, suggesting a protective effect of these cells, as opposed to a more pathogenic contribution of Vgamma1(+)/Vdelta1(+) cells.
Bank
I
I
Department of Medicine F and Laboratory for Immunoregulation, Chaim Sheba Medical Centre, Sackler School of Medicine, Tel Hashomer, Israel. ibank@post.tau.ac.il
Cohen
L
L
Mouallem
M
M
Farfel
Z
Z
Grossman
E
E
Ben-Nun
A
A
D000368:Aged; D001168:Arthritis / Q000276:immunology*; D002908:Chronic Disease; D005260:Female; D005434:Flow Cytometry; D019672:Genes, T-Cell Receptor; D006801:Humans; D007111:Immunity, Cellular; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000276:immunology*; D016133:Polymerase Chain Reaction; D016692:Receptors, Antigen, T-Cell, gamma-delta; D013583:Synovial Membrane / Q000276:immunology*; D016176:T-Lymphocyte Subsets / Q000276:immunology*
D016692:Receptors, Antigen, T-Cell, gamma-delta