Abnormal T cell receptor V gene usage in myasthenia gravis: Prevalence and characterization of expanded T cell populations

Abstract

The usage of T cell receptor (TCR) Vα/Vβ chains on cells from 38 patients with myasthenia gravis (MG) was determined by flow cytometry. There was a decreased number of cells expressing Vβ2 in CD8+ and Vβ3 in CD4+ cells in patients compared with healthy individuals. Abnormal expansions of T cells using particular TCR Vα/Vβ gene products were found in 18/38 patients. A significantly higher usage of Vβ13 was observed but there was no restriction with regard to other TCR Vα/Vβ. Expanded cells belonging to both CD4+ and CD8+ were present in MG patients while restricted to the CD8+ population in healthy individuals. To elucidate the role of the expanded populations, we studied characteristics of the expanded and non- expanded T cells from MG patients who had persistent T cell expansions over more than 2 years. The cells were analysed with regard to phenotype, cytokine secretion, cytokine mRNA expression and reactivity with the autoantigen, the acetylcholine receptor. The characteristics of the expanded populations in MG clearly differed from those found in healthy individuals. More cells in the CD4+ expanded populations expressed HLA-DR and there was also a tendency for higher expression of CD25, CD28 and CD57. The number of cells spontaneously secreting cytokines was higher in the expanded populations. A dominant Th1- type cytokine secretion and mRNA expression was noted. Autoantigen-reactive CD4+ T cells were largely restricted to the expanded populations.