Schaufelberger C, Andersson R, Nordborg E, Hansson G K, Nordborg C, Wahlström J
Department of Rheumatology, Sahlgrenska University Hospital, 413 45, Göteborg, Sweden.
Inflammation. 2008 Dec;31(6):372-83. doi: 10.1007/s10753-008-9088-9.
The aim of the study was to investigate T cell receptor (TCR) usage at the time of diagnosis of giant cell arteritis (GCA) and to estimate the degree of clonality of T-cells infiltrating the lesion. Seven patients with biopsy-proven giant cell arteritis were included in the study. Immunocytochemistry in biopsies from the temporal arteries and flow cytometric analysis of peripheral blood lymphocytes (PBL) was performed using monoclonal antibodies specific for CD3, CD4 and CD8 and 13 TCR Valpha and Vbeta gene segment products. The CDR3 fragment length polymorphism was assessed by gel electrophoresis of PCR-amplified TCR segments. The T lymphocytes were found to be concentrated to the adventitia rather than the media or intima. Six of the seven patients with GCA had expansions of T lymphocytes, expressing selected TCR V genes in the arterial wall. None of these expansions was found in PBL. The infiltrating T-cells were poly- or oligoclonal. In conclusion, the dominating part of the inflammatory infiltrate in GCA emanates from the adventitial microvessels. There is an uneven expression of TCR V genes by T lymphocytes in the inflammatory infiltrates as compared to peripheral blood T lymphocytes at the time of diagnosis, consistent with an antigen-driven immunological reaction in the arterial wall.
本研究的目的是调查巨细胞动脉炎（GCA）诊断时T细胞受体（TCR）的使用情况，并评估浸润病变的T细胞的克隆程度。七名经活检证实为巨细胞动脉炎的患者被纳入本研究。使用针对CD3、CD4和CD8以及13种TCR Vα和Vβ基因片段产物的单克隆抗体，对颞动脉活检组织进行免疫细胞化学检测，并对外周血淋巴细胞（PBL）进行流式细胞术分析。通过PCR扩增的TCR片段的凝胶电泳评估CDR3片段长度多态性。发现T淋巴细胞集中在外膜而非中膜或内膜。七名GCA患者中有六名的T淋巴细胞出现扩增，在动脉壁中表达选定的TCR V基因。在PBL中未发现这些扩增情况。浸润的T细胞为多克隆或寡克隆。总之，GCA中炎症浸润的主要部分源自外膜微血管。与诊断时的外周血T淋巴细胞相比，炎症浸润中的T淋巴细胞TCR V基因表达不均衡，这与动脉壁中抗原驱动的免疫反应一致。
