Persistence of T-cell clones in psoriatic lesions.

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Abstract
Background: We previously demonstrated a clonal dominance in the Vβ13.1 messages isolated from the lesional CD8+T cells of psoriasis vulgaris, which suggested an interaction of Vβ13.1+CD8+T cells with skin antigens. Objectives: To determine whether the clonality observed accurately reflected a clonal population of infiltrating T cells or was skewed by an overabundance of messages from a small number of cells, and to extend our study of Vβ gene usage by lesional CD8+T cells to 9 new patients. Design: Case study. Setting: Patients were enrolled at the Psoriasis Research Institute in Palo Alto, Calif, and samples were analyzed at The Immune Response Corporation in Carlsbad, Calif. Main Outcome Measures: For the 2 previous patients, skin samples were sorted directly for Vβ13.1+T cells, for which the T-cell receptors were sequenced. For the 9 new patients, CD8+T cells were sorted and their T-cell receptor Vβ gene usage measured using semiquantitative polymerase chain reaction with Vβ-specific primers. Results: The directly sorted Vβ13.1+T cells exhibited clonal dominance in both patients. The dominant Vβ13.1 clone in each patient was the same as that found in the previous 2 biopsy specimens for which CD8+T cells were sorted. Additionally, in 8 of the 9 new patients examined, we again found a preferential usage of Vβ3 and/or Vβ13.1 genes by the lesional CD8+T cells. Conclusions: The clonality, which was found in the Vβ messages of the sorted CD8+T cells, accurately reflects the dominance of these clones in the infiltrating T cells. Moreover, the persistence in the same patient of the same clone for as long as 15 months and the overrepresentation of Vβ3 and/or Vβ13.1 in lesional CD8+T cells in the new patients examined support the pathogenic role of T cells bearing these Vβs. Arch Dermatol. 1997;133:703-708