klebsiella pneumoniae‐reactive t cells in blood and synovial fluid of patients with ankylosing spondylitis comparison with hla–b27 + healthy control subjects in a limiting dilution study and determination of the specificity of synovial fluid t cell clones

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Abstract
Objective. To study the frequency of Klebsiella pneumoniae–responsive T cells in the peripheral blood (PB) of ankylosing spondylitis (AS) patients compared with that in healthy HLA–B27+ donors, and to examine T lymphocyte clones (TLC) derived from AS patient synovial fluid (SF) for the presence of Klebsiella reactivity.Methods. Limiting dilution analysis of PB T cells in 8 patients with active AS and in 8 HLA–B27+ healthy subjects was used to determine the frequency of PB T cells responsive to K pneumoniae and Escherichia coli GroEL. SF T cells from a patient with active AS were cloned, and 125 TLC were characterized in proliferation assays.Results. There were fewer T cells in the PB of AS patients that reacted with K pneumoniae than in the PB of healthy HLA–B27+ subjects. The frequencies of E coli GroEL–responsive T cells were ∼5–10 times lower in all subjects tested (healthy donors and AS patients), but without significant differences between the 2 groups. Two CD4+ TLC that recognized K pneumoniae (1 cross‐reactive with E coli) as well as 3 TLC that recognized GroEL (2 CD4+, 1 T cell receptor γ/δ+) were isolated from the SF of a patient with active AS.Conclusion. Our results indicate that there is a quantitative reduction of K pneumoniae‐responsive T cells in the PB of AS patients as compared with healthy controls. This may reflect a defective peripheral T cell defense in the immune response to Klebsiella and may allow bacterial antigens to reach the synovium, where they initiate specific T cell responses.

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