CD4 T-CELLS IN THE RHEUMATOID JOINT ARE OLIGOCLONALLY ACTIVATED AND CHANGE DURING THE COURSE OF DISEASE

Objective-To assess the nature of T cell receptor (TCR) utilisation by CD4 T cells in the rheumatoid joint. Methods-Sequencing of the joinin g (NDJ) region of TCR beta chain mRNA isolated from synovial fluid CD4 T cells was performed in three patients in order to determine if olig oclonal expansion of particular sequences was present. Two patients we re studied longitudinally to determine if these sequences changed over time. Results-A number of dominant clonotypes were found within the T CR transcripts sequenced in each patient. In the two patients who were studied longitudinally, different dominant clonotype were detected ov er time. No single clonotype was persistently dominant during the peri od of study. Conclusions-The pattern of TCR usage showed multiple olig oclonally expanded CD4 T cells within the rheumatoid joint. The change in clonotypes within the joint over time suggests that different anti gens may be able to elicit synovial inflammation during the course of rheumatoid disease.