1. A cd8 alpha-negative subset of cd4+slamf7+ cytotoxic t cells is expanded in patients with igg4-related disease and decreases following glucocorticoid treatment
- Author
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DELLA TORRE E, E. Bozzalla Cassione, C. Sciorati, M. Lanzillotta, E. Bozzolo, L. Rovati, H. Mattoo, C. Perugino, J. Stone, L. Dagna, S. Pillai, A. Manfredi, DELLA TORRE, E, Bozzalla Cassione, E., Sciorati, C., Lanzillotta, M., Bozzolo, E., Rovati, L., Mattoo, H., Perugino, C., Stone, J., Dagna, L., Pillai, S., and Manfredi, A.
- Subjects
LYMPHOCYTES - Abstract
Background: IgG4-Related Disease (IgG4-RD) is a fibro-inflammatory disorder characterised by tumefactive lesions, frequent elevation of serum IgG4 levels, and tissue fibrosis.1 Glucocorticoids represent the treatment of choice to induce IgG4-RD remission but their effect on the cells orchestrating the disease remains unknown.1 We recently describerd an unconventional population of clonally expanded CD4+SLAMF7+ cytotoxic T effector memory (TEM) cells (CD4+CTLs) and causally linked it to IgG4-RD in view of their capacity to secrete pro-fibrotic molecules and to infiltrate affected organs.2–4Objectives: In order to better clarify the mechanisms of action of glucocorticoids in IgG4-RD and the pathogenic relevance of CD4+ CTLs, we herein aim to describe the effects of corticosteroid treatment on CD4+ CTLs.Methods: CD8α, granzyme A, perforin, and SLAMF7 expression within the effector/memory compartment of CD45RO (TEM) and CD45RA (TEMRA) CD4+ T cells was quantified by flow cytometry in 18 active IgG4-RD patients at baseline and after 6 months of glucocorticoid treatment. Eighteen healthy subjects were studied as controls. Next-generation sequencing of the T-cell receptor α and β chain gene was performed on circulating CD4+CTLs in patients with IgG4-RD before and after treatment, and in affected tissues.Results: Circulating CD4+ TEM and TEMRA cells were not expanded in IgG4-RD patients compared to healthy controls. CD4+SLAMF7+ TEM cells (but not TEMRA cells) were significantly increased among IgG4-RD patients. Within CD4+SLAMF7+ TEM cells, CD8α- but not CD8αlow cells were elevated in IgG4-RD patients. The same dominant clones of CD8α-CD4+SLAMF7+ TEM cells found in the peripheral blood were also identified in affected tissue. Both CD8α- and CD8αlow CD4+SLAMF7+ TEM cells expressed cytolytic molecules. Clonally expanded CD8α- but not CD8αlow CD4+SLAMF7+ TEM cells decreased following glucocorticoid-induced disease remission.Conclusions: A subset of CD8α-CD4+SLAMF7+ cytotoxic TEM cells is oligoclonally expanded in patients with active IgG4-RD. This population contracts following glucocorticoid-induced remission. Further characterisation of this cell population may provide prognostic information and targets for therapeutic intervention.
- Published
- 2018