γδ T cell subsets in patients with arthritis and chronic neutropenia

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Abstract
Background: An abnormal distribution of subsets of γδ T cells, which are a component of the inflammatory infiltrate in arthritic synovium, has been demonstrated in the peripheral blood (PB) of patients with arthritis and neutropenia. Objective: To evaluate whether the clinical manifestations of patients with arthritis and neutropenia are related to the specific γδ T cell subset predominant in the PB. Methods: Flow cytometry of PB lymphocytes in six consecutive patients with chronic neutropenia and arthritis was performed. Variable (V) γ and δ gene families were analysed by polymerase chain reaction. cDNA was subjected to direct automated sequencing of T cell receptor (TCR) genes. Results: Three patients had non-deforming and non-erosive rheumatoid factor (RF)+ polyarticular rheumatoid arthritis, RF+ oligoarticular arthritis, or RF− non-deforming oligoarticular psoriatic arthritis with persistent expansions of Vγ1+/Vδ2+, Vγ2+/Vδ2+, or Vγ1+/Vδ undetermined (2− 1−) T cells, respectively. The other three patients, without persistent expansion of γδ T cells, had either non-deforming and non-erosive oligo- or polyarthritis with a balanced distribution of several Vδ and Vγ genes, or severe erosive RF+ arthritis with deficiency of all but Vγ1+/Vδ1+ T cells. Conclusions: γδ T cell lymphoproliferations in chronic neutropenia and arthritis use different Vγ and Vδ gene families, often forming T cell receptor (TCR) structures that are infrequent in normal adult PB. Arthritis with Vγ1+/Vδ2+, Vγ2+/Vδ2+, or Vγ1+/Vδ2−/Vδ1− γδ T cells in the PB is non-deforming and non-erosive, suggesting a protective effect of these cells, as opposed to a more pathogenic contribution of Vγ1+/Vδ1+ cells.