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T cells in reactive arthritis
Author(s) -
HERMANN ELISABETH
Publication year - 1993
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1699-0463.1993.tb00099.x
Subject(s) - immunology , cytotoxic t cell , synovial fluid , antigen , t cell , antigen presenting cell , t cell receptor , biology , interleukin 21 , cd8 , immune system , medicine , pathology , in vitro , osteoarthritis , biochemistry , alternative medicine
T cells appear to play a major role in the development, maintenance and also resolution of reactive arthritis (ReA). Recent advances in understanding the processes involved in T cell activation now allow us to examine the peripheral blood and synovial fluid T cell responses to given “arthritogenic” microorganisms in terms of antigen specificity, epitope identification, cytokine secretion patterns, HLA restriction and the role of different T cell subsets in ReA. Peripheral blood bulk proliferation and limiting dilution studies provide evidence that the peripheral T cell response against arthritis‐associated gram‐negative bacteria is decreased in patients developing immunological sequelae such as ReA after gastrointestinal infection. Using clonal analysis of synovial fluid CD4 + T cells it has been shown that a polyclonal rather than an oligoclonal response to a variety of bacterial antigens is induced at the site of synovitis and that these CD4 + T cells produce a T h l‐type of cytokine. 65 kD heat shock protein may represent one of the possible linkages of anti‐infectious and autoimmune reactions. Furthermore, a spectrum of killer cells is present in the synovial fluid of patients with ReA. This spectrum of cytotoxic T cells includes antigen‐specific, class I‐restricted αβ‐TCR + CD8 + lymphocytes, antigen‐specific, apparently non‐MHC‐restricted αβ‐TCR + CD8 + lymphocytes and γδ‐TCR + cells with broad cytolytic activity directed against bacteria‐infected target cells. HLA‐B27‐restricted Yersinia ‐ or Salmonella ‐specific synovial fluid CD8 + T cells may provide the missing link between genetic disposition (HLA‐B27) and extra‐articular infection with arthritogenic bacteria in these patients.