TCR rearrangement in patients with eosinophilic lung disease

Ref ID: 18407

Author:

Nathalie Freymond , Vincent Cottin, Chahéra Khouatra ,
Jean-Emmanuel Kahn, Nadia Sivova, Lionel Prin , Fanny Legrand,
Jean-François Cordier

Author address:

National Reference Center for Rare Pulmonary
Diseases, Louis Pradel Hospital, Lyon, France; Department of Internal
Medicine, Foch Hospital, Suresnes, France; Immunology Laboratory, University
Hospital, Lille, France

Full conference title:

European Respiratory Congress

Abstract:

Background: Expansion of monoclonal population of T-cells with T-cell receptor
(TCR) rearrangements and aberrant cell surface immunophenotype produce
IL-5 and contribute to the pathophysiology of the lymphocytic variant of the
hypereosinophilic syndrome (HES).
Objective: To characterise T-cell expansion in eosinophilic lung disease.
Methods: T-cell expression profile was analysed by flow cytometry and TCR
clonal gene rearrangements were studied by PCR in 45 consecutive patients with
peripheral blood eosinophilia (greater than 1.0x 109/L) and eosinophilic lung disease.
Patients with myeloid or lymphocytic variants of HES or any identified cause
of eosinophilia were excluded.
Results: Clonal TCR rearrangements were detected in 11/45 patients (24%):
4/18 with hypereosinophilic asthma, 3/17 with Churg-Strauss syndrome, 3/9 with
idiopathic chronic eosinophilic pneumonia (ICEP), and 1/1 with allergic bronchopulmonary
aspergillosis. Seven patients had 2 clonal rearrangements or more.
TCR rearrangements involved the TCRγ chain in 10 patients and the TCRδ chain
in one patient with ICEP. Aberrant T-cell immunophenotype usually found in HES
(CD3-CD4+, CD3+CD4-CD8-, or CD3+CD7)- , and known to produce IL-5, was
not detected. No significant clinical or biological difference was found between
patients with or without clonal TCR gene rearrangements. IL-5 serum level was
normal in all patients.
Conclusion: Expansion of TCR-Vγ or TCR-Vδ populations are present in a
proportion of patients with eosinophilic lung disease without aberrant cell-surface
immunophenotype. Further study is needed to evaluate whether T-cell clonality
might contribute to the pathophysiology of these conditions or is only a transient
reactive phenomenon.

Abstract Number: P1835

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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