STIMULATION OF PERIPHERAL-BLOOD LYMPHOCYTES WITH CAMPYLOBACTER-JEJUNIGENERATES A GAMMA-DELTA T-CELL RESPONSE IN PATIENTS WITH GUILLAIN-BARRE-SYNDROME

In three patients whose Guillain-Barre syndrome (GBS) was preceded by gastrointestinal infection due to Campylobacter jejuni, gamma delta T cells were generated from peripheral blood in response to in vitro sti mulation with C. jejuni. In one of the patients, where a diagnostic su ral nerve biopsy was performed, gamma delta T cells were also isolated following culture of the nerve tissue. Studies with healthy volunteer s and C. jejuni gastroenteritis patients also showed preferential enri chment for gamma delta T cells in peripheral blood cells stimulated wi th C. jejuni, although the response was significantly lower than that seen in GBS patients. In two out of three GBS patients and all of the controls, gamma delta T cell receptor (TCR) gene usage was shown to be V gamma 9/V delta 2(+). In the GBS patient where nerve-infiltrating g amma delta T cells were isolated, these and C. jejuni-specific periphe ral blood cells had similar TCR gene usage, predominantly consisting o f V gamma 5/V delta 1(+) cells. Sequencing the V delta 1 products from nerve and peripheral blood showed similarities in CDR3 length, but th e single V delta 1 sequence obtained from nerve was not identified in peripheral blood. These results suggest that the generation of gamma d elta T cells is part of a normal immune response to C. jejuni, which, in patients with GBS, may contribute to the pathogenesis of their infl ammatory neuropathy.