Objective
Type II collagen (CII) is a cartilage-specific protein to which a loss of immune tolerance may trigger autoimmune reactions and cause arthritis. The major T cell epitope on CII, aa259-273, can be presented by several HLA-DRB1*04 alleles in its native or posttranslational-glycosylated form. Here, we aimed to functionally explore and compare CII-autoreactive T cells from blood and synovial fluid of patients with rheumatoid arthritis (RA).
Methods
Peripheral blood were obtained from HLA-DRB1*04 RA and control subjects (n=10 each), then stimulated in vitro with several variants of the CII259-273 epitope: (a) unmodified, or glycosylated on (b) lysine-264, (c) lysine-270, or (d) both lysine-264 and 270. Upregulation of CD154 was used to identify responding T cells. These cells were further characterized by intracellular staining for IL-17, IFNγ and IL-2 by flow cytometry. For RA patients, synovial T cells were investigated in parallel.
Results
Multifunctional T cell responses towards all examined variants of the CII259-273 peptide could be detected in RA patients and to a lesser extent also in healthy HLA-matched individuals (p<0.001). In RA, a comparison between blood and joint-derived T cell function revealed a significant increase of the proinflammatory cytokine IFNγ (p=0.027) in synovial T cells. Studies of longitudinal samples show that T cell responses were sustained over the course of disease, and even included epitope spreading.
Conclusions
The identification of inflammatory T cell responses to both glycosylated and non-glycosylated variants of the major CII epitope in RA patients suggests that CII autoreactivity may be more common than previously appreciated.