Abstract

HLA-DRB1 gene variants are known risk factors for several immunological diseases. Patients with rheumatoid arthritis (RA) often carry HLA-DRB1*04 (DR4+), and have a repertoire of collagen IIp261-273specific T cells in the peripheral blood at the onset of the disease. Gabriele Di Sante (Rome, Italy) and colleagues enrolled 90 patients with early RA to determine whether this subset of DR4-restricted collagen-specific T cells could represent new markers of severity of the disease and response to therapy. The authors examined the usage of T-cell receptor (TCR)-beta chains in peripheral blood mononuclear cells cultured with or without the human collagen II peptide p261273. They found that the presence of T cells carrying TCR-beta chains TRBV25 and TRBV6_4was correlated toHLA-DR and RA disease activity, and the detection of TRBV25 T cells could predict active disease in DR4+ patients. HLA-DRB1*04/04, 04/01 and 04/11 alleles were significantly associated with TRBV25 usage, higher disease activity at RA onset, and poor response to disease-modifying anti-rheumatic drugs. The findings could help predict the course of RA and tailor treatments for RA patients.

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