CROHNS-DISEASE (CD) PATIENTS SUFFERING FROM PERIPHERAL ARTHRITIS OR ANKYLOSING-SPONDYLITIS REVEAL RESTRICTED T-CELL RECEPTOR V-BETA REGIONSIN DIFFERENT TEMPORAL PHASES OF DISEASE

Little is known about the mechanisms triggering and controlling both t he development and perpetuation of extraintestinal complications in CD . The aim of the present study was to test the hypothesis that the T c ell immune response in CD patients with joint complications may be alt ered when compared with patients without extraintestinal manifestation s. We used a semiquantitative polymerase chain reaction assay to analy se the T cell antigen receptor repertoire in peripheral blood T cells from eight CD patients suffering from peripheral arthritis and ankylos ing spondylitis, 12 CD patients without extraintestinal manifestations , and from seven non-CD patients with ankylosing spondylitis showing t ypical changes on joint radiographs. Being concerned that different pa tterns may be seen in different phases of the inflammatory disease pro cess, we have also taken care to analyse sequential samples at various time points of the disease. Expression of all 22V beta genes was foun d in each healthy control and in each CD patient without extraintestin al manifestations and showed no major variation over time. Southern hy bridization analysis of amplified products revealed a highly restricte d V beta repertoire in all CD patients suffering from peripheral arthr itis and ankylosing spondylitis. In contrast, non-CD patients with ank ylosing spondylitis without signs or symptoms of gastrointestinal prob lems demonstrated the presence of the entire V beta repertoire. Our lo ngitudinal studies confirmed variable V beta usage over time, as certa in transcripts were found only in distinct temporal phases of disease. Our data are not directly suggestive of a common superantigen model o f CD, but instead emphasize a specific decrease in signals throughout the T cell receptor V beta repertoire in CD patients suffering from jo int complications.