Several lines of evidence argue in favour of an involvement of T cells
in the pathogenesis of Wegener's granulomatosis (WG). These include t
he presence of highly specific IgG autoantibodies to proteinase 3, per
ivascular T-cell infiltrates and elevated amounts of soluble interleuk
in-2 (IL-2) receptors in patient's serum. In order to further address
this question we evaluated by double immunoflourescence and flow cytom
etry the expression of several cell surface molecules associated with
T-cell activation. As compared to healthy controls (n=15), the CD4(+)
subset was significantly diminished, while the percentage of CD8(+) T
cells was elevated in WG patients (n=24). Within the CD4(+) T-cell sub
set we found a highly significant increase in activation/memory marker
s (CD25, CD29, HLA-DR). Within the CD8(+) T-cell subset the expression
of CD11b, CD29 and CD57 was significantly elevated, while the express
ion of VD28 was reduced. The use of 10 V beta-, 1 V alpha- and 1 V gam
ma-specific monoclonal reagents failed to reveal any significant bias
in the peripheral T-cell receptor V-gene repertoire of WG patients. Th
ere was also no correlation between T-cell activation markers and labo
ratory parameters [C-reactive protein (CRP), ESR], disease duration or
therapy. A significant correlation was found only for the degree of o
rgan involvement and the increase in CD4(+) T cells coexpressing HLA-D
R, as well as the increase in CD57 expression on CD8(+) T cells. In co
nclusion, both CD4(+) and CD8(+) T-cell subsets were activated in WG.
Cytotoxic CD8(+) CD57(+) CD11b(+) CD28(-) T cells may directly contrib
ute to damage of vascular endothelium.