title: Recovery of the T-cell repertoire in CIDP by IV immunoglobulins.
abstract: OBJECTIVE
  To investigate changes in the T-cell repertoire in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) without and with treatment of IV immunoglobulins (IVIg).
  
  
  METHODS
  The T-cell receptor (TCR) repertoire of CD4+ and CD8+ T cells in the peripheral blood was analyzed using CDR3 spectratyping. Patients with CIDP were included without (n = 14) and with IVIg treatment (n = 11) cross-sectionally and longitudinally (n = 2).
  
  
  RESULTS
  While the TCR length distribution of patients with CIDP was only moderately altered for most of the Vβ elements of CD4+ T cells, the CD8+ population displayed extensive oligoclonal expansions in all analyzed 24 Vβ elements. A public expansion of a distinct TCR length in one Vβ element within a majority of affected patients was not detectable. Treatment with IVIg reduced the oligoclonal expansions within both the CD4+ and CD8+ population.
  
  
  CONCLUSIONS
  Our data demonstrate that cytotoxic CD8+ T cells exhibit a much broader activation than CD4+ T cells, indicating a potentially crucial role of CD8+ T cells in the immunopathogenesis of CIDP. The profound oligoclonal response in T-cell activation suggests that multiple peptides may induce and propagate this autoimmune-driven disease. The observed reduction of highly activated T cells may contribute to the therapeutic effects of IVIg.
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany. mausberg@uni-duesseldorf.de
authors.forename: Anne K
authors.initials: AK
authors.lastname: Mausberg
authors.forename: Mareike
authors.initials: M
authors.lastname: Dorok
authors.forename: Mark
authors.initials: M
authors.lastname: Stettner
authors.forename: Matthias
authors.initials: M
authors.lastname: Müller
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Thomas
authors.initials: T
authors.lastname: Dehmel
authors.forename: Clemens
authors.initials: C
authors.lastname: Warnke
authors.forename: Gerd
authors.initials: G
authors.lastname: Meyer Zu Hörste
authors.forename: Bernd C
authors.initials: BC
authors.lastname: Kieseier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy*; D011948:Receptors, Antigen, T-Cell / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology*
chemical_list: D016756:Immunoglobulins, Intravenous; D011948:Receptors, Antigen, T-Cell