title: Oligoclonal CD4+ T cells in the lungs of patients with severe emphysema.
abstract: BACKGROUND
  Within the lungs of patients with severe emphysema, inflammation continues despite smoking cessation. Foci of T lymphocytes in the small airways of patients with emphysema have been associated with disease severity. Whether these T cells play an important role in this continued inflammatory response is unknown.
  
  
  OBJECTIVE
  The aim of this study was to determine if T cells recruited to the lungs of subjects with severe emphysema contain oligoclonal T-cell populations, suggesting their accumulation in response to antigenic stimuli.
  
  
  METHODS
  Lung T-cell receptor (TCR) Vbeta repertoire from eight patients with severe emphysema and six control subjects was evaluated at the time of tissue procurement (ex vivo) and after 2 weeks of culture with interleukin 2 (in vitro). Junctional region nucleotide sequencing of expanded TCR-Vbeta subsets was performed.
  
  
  RESULTS
  No significantly expanded TCR-Vbeta subsets were identified in ex vivo samples. However, T cells grew from all emphysema (n = 8) but from only one of the control lung samples (n = 6) when exposed to interleukin 2 (p = 0.0013). Within the cultured cells, seven major CD4-expressing TCR-Vbeta subset expansions were identified from five of the patients with emphysema. These expansions were composed of oligoclonal populations of T cells that had already been expanded in vivo.
  
  
  CONCLUSIONS
  Severe emphysema is associated with inflammation involving T lymphocytes that are composed of oligoclonal CD4+ T cells. These T cells are accumulating in the lung secondary to conventional antigenic stimulation and are likely involved in the persistent pulmonary inflammation characteristic of severe emphysema.
authors.affiliation: Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Sullivan
authors.forename: Philip L
authors.initials: PL
authors.lastname: Simonian
authors.forename: Michael T
authors.initials: MT
authors.lastname: Falta
authors.forename: John D
authors.initials: JD
authors.lastname: Mitchell
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Cosgrove
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Brown
authors.forename: Brian L
authors.initials: BL
authors.lastname: Kotzin
authors.forename: Norbert F
authors.initials: NF
authors.lastname: Voelkel
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Fontenot
mesh_terms: D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002999:Clone Cells / Q000276:immunology; D005260:Female; D006801:Humans; D008168:Lung / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000276:immunology*; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000276:immunology
chemical_list: D016693:Receptors, Antigen, T-Cell, alpha-beta