title: In situ diversification of the antibody repertoire in chronic Lyme arthritis synovium.
abstract: Lyme arthritis is initiated by the tick-borne spirochete, Borrelia burgdorferi. In a subset of patients, symptoms do not resolve in response to standard courses of antibiotics. Chronic joint inflammation may persist despite spirochetal killing, suggesting an autoimmune etiology. The pathogenic mechanisms that sustain chronic Lyme arthritis have not been fully elucidated, although T cells are believed to play a role. The synovial lesion contains elements of a peripheral lymph node, with lymphoid aggregates, plasma cells and follicular dendritic cells. An analysis of activated cells at the site of injury could yield clues regarding the nature of the response and the identity of potential autoantigens. Using laser-capture microdissection, we have isolated plasma cells from the joint tissue of chronic Lyme arthritis patients who underwent synovectomy. Expressed Ig V regions were amplified by RT-PCR. A majority of isolated cells expressed gamma H chains, which is indicative of a class-switched response. There were a large number of nucleotide substitutions from germline, with a higher fraction of replacement mutations in the CDRs, suggesting a process of Ag-driven selection. We have recovered clonal clusters of cells containing identical junctions and V(D)J rearrangements. Sequence analysis reveals a hierarchy of shared somatic mutations between members of a given clone. Intraclonal diversity among plasma cells of close physical proximity points toward an ongoing process of diversification and affinity maturation, possibly driven by the chronic presence of an autoantigen.
authors.affiliation: Department of Pathology, Tufts University School of Medicine, Boston, MA 02111, USA.
authors.forename: Srimoyee
authors.initials: S
authors.lastname: Ghosh
authors.forename: Allen C
authors.initials: AC
authors.lastname: Steere
authors.forename: B David
authors.initials: BD
authors.lastname: Stollar
authors.forename: Brigitte T
authors.initials: BT
authors.lastname: Huber
mesh_terms: D000595:Amino Acid Sequence; D000907:Antibodies, Bacterial / Q000096:biosynthesis* / Q000235:genetics*; D000916:Antibody Diversity / Q000235:genetics*; D001483:Base Sequence; D025065:Borrelia burgdorferi / Q000276:immunology; D002908:Chronic Disease; D002999:Clone Cells; D004252:DNA Mutational Analysis; D019084:Fluorescent Antibody Technique, Indirect; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D015328:Gene Rearrangement, B-Lymphocyte, Light Chain; D006801:Humans; D007135:Immunoglobulin Variable Region / Q000096:biosynthesis / Q000235:genetics; D008193:Lyme Disease / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D008969:Molecular Sequence Data; D010950:Plasma Cells / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D017434:Protein Structure, Tertiary; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013583:Synovial Membrane / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*
chemical_list: D000907:Antibodies, Bacterial; D007135:Immunoglobulin Variable Region