Distinct TCR δ repertoires are present in the cutaneous lesions and inflamed duodenum of patients with dermatitis herpetiformis

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Abstract
Intraepithelial γδ T cells are increased in the inflamed small bowel and are also found in increased numbers in cutaneous lesions from patients with dermatitis herpetiformis (DH). Thus, these cells might play an important role in the pathogenesis of the disease. We investigated the T‐cell receptor (TCR) δ repertoire in involved and non‐involved skin and compared it with the TCR δ repertoire of the inflamed duodenum and peripheral blood of the same patients. An identical TCR δ repertoire in the small bowel and in the cutaneous lesions would suggest a migration of antigen‐specific γδ T cells from the intestine to the skin which cross‐react with cutaneous antigens. T‐cell receptor DV1‐DV3 transcripts were amplified by reverse transcriptase (RT)‐PCR and analyzed by complementarity determining region 3 (CDR3) size spectratyping and nucleotide sequencing. Our results indicate that the cutaneous TCR δ repertoires were oligoclonal and identical dominant γδ T‐cell clones were present in the involved and non‐involved skin. Furthermore, the TCR δ repertoire of the skin was distinct from that in the small bowel. The peripheral blood exhibited a restricted TCR δ repertoire, which differed from that in the intestine and skin. Thus, cutaneous γδ T cells are not specifically expanded within the involved skin and are unlikely to be derived from the inflamed duodenum.