ISOLATION AND CHARACTERIZATION OF T-LYMPHOCYTES FROM SURAL NERVE BIOPSIES IN PATIENTS WITH GUILLAIN-BARRE-SYNDROME AND CHRONIC INFLAMMATORYDEMYELINATING POLYNEUROPATHY

Objectives-To characterise cultured T lymphocytes from nerve biopsies in patients with Guillain-Barre syndrome and chronic inflammatory demy elinating polyneuropathy (CIDP). Methods-Sural nerve biopsies, obtaine d from six patients with Guillain-Barre syndrome, four with CIDP, and six controls with other neuropathies, were cultured with 20 U/ml recom binant interleukin-2 (IL-2) for eight weeks. Flow cytometry was used t o determine the phenotype of cultured T lymphocytes. Their proliferati ve responses to a range of bacterial antigens were also examined. Resu lts-T cell lines were established from four of six patients with Guill ain-Barre syndrome, one of four with CIDP, one patient with peripheral nerve vasculitis, and none of five controls with noninflammatory neur opathies. One of these T cell lines from a patient with Guillain-Barre syndrome, preceded by Campylobacter jejuni infection, consisted entir ely of gamma delta TCR(+) T lymphocytes. The peripheral blood of this patient also contained an increased frequency of gamma delta T cells w hen stimulated with C jejuni. The nerve derived T cell lines failed to show a proliferative response to bacterial antigens or to a preparati on of myelin proteins. Conclusions-A new technique to isolate T cells from nerve biopsies in patients with Guillain-Barre syndrome and CIDP is reported. This technique may prove to be a useful tool in the inves tigation of the pathogenesis of other inflammatory neuropathies such a s peripheral nerve vasculitis. The isolation of a gamma delta TCR(+) n erve T Pathology cell line is of interest because of the possibility t hat these cells might respond to glycolipid epitopes common to C jejun i and peripheral nerve gangliosides.