PT  - JOURNAL ARTICLE
AU  - J Wahlstrom
AU  - M Berlin
AU  - R Lundgren
AU  - O Olerup
AU  - H Wigzell
AU  - A Eklund
AU  - J Grunewald
TI  - Lung and blood T-cell receptor repertoire in extrinsic allergic alveolitis
AID  - 10.1183/09031936.97.10040772
DP  - 1997 Apr 01
TA  - European Respiratory Journal
PG  - 772--779
VI  - 10
IP  - 4
4099  - http://erj.ersjournals.com/content/10/4/772.short
4100  - http://erj.ersjournals.com/content/10/4/772.full
SO  - Eur Respir J1997 Apr 01; 10
AB  - Patients with extrinsic allergic alveolitis (EAA) have accumulations of T-lymphocytes in their lungs. CD8+ lung T-cells, in particular, have been implicated in the pathogenesis of EAA. The objective of the present study was to analyse the T-cell receptor (TCR) V alpha and V beta gene usage of CD4+ and CD8+ lung and peripheral blood lymphocytes (PBLs) before and after treatment. Twelve patients with clinical signs of extrinsic allergic alveolitis were studied at disease onset, and nine of the 12 were also studied after treatment and clinical recovery. Lung cells, obtained by bronchoalveolar lavage (BAL), and paired PBL samples were analysed by flow cytometry using a panel of anti-TCR V monoclonal antibodies. The changes in TCR V gene usage were most pronounced in BAL CD8+ cells, as compared to the BAL CD4+, PBL CD8+ and PBL CD4+ subsets. At disease onset, 10 of the 12 patients had lung restricted expansions of CD8+ T-cells using a particular V alpha or V beta gene segment, and 8 of the 12 patients had CD8+ T-cell expansions in PBL. For the patients in whom a follow-up was possible, a majority of the expansions in the lungs were normalized, whereas most of the expansions in PBL remained. An over-representation of human leucocyte antigen (HLA)-DR2 (15) was detected, particularly among patients with farmer's lung. An increased selected T-cell receptor V gene usage may follow specific interactions between T-cells and antigens. In extrinsic allergic alveolitis, we determined that such expansions occur most frequently in the lung CD8+ T-cells. Since most expansions of lung CD8+ T-cells normalized with clinical improvement, these are further implicated in the pathogenesis of extrinsic allergic alveolitis.