1. Next‐Generation Immunosequencing Reveals Pathological T‐Cell Architecture in Autoimmune Hepatitis
- Author
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Christina Weiler-Normann, Lorenzo F. Fanchi, Christoph Schultheiß, Nicola Bonzanni, Donjete Simnica, Nils H. Wildner, Julian Schulze zur Wiesch, Mascha Binder, Ansgar W. Lohse, Anna Oberle, and Edith Willscher
- Subjects
Adult ,Male ,0301 basic medicine ,T-Lymphocytes ,medicine.medical_treatment ,T cell ,B-cell receptor ,Receptors, Antigen, T-Cell ,Receptors, Antigen, B-Cell ,Hepacivirus ,Autoimmune hepatitis ,Human leukocyte antigen ,Chronic liver disease ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,immune system diseases ,Humans ,Medicine ,B cell ,Aged ,Aged, 80 and over ,Immunosuppression Therapy ,B-Lymphocytes ,Hepatology ,Liver Cirrhosis, Biliary ,business.industry ,T-cell receptor ,High-Throughput Nucleotide Sequencing ,Immunosuppression ,Middle Aged ,medicine.disease ,Hepatitis C ,Hepatitis, Autoimmune ,030104 developmental biology ,medicine.anatomical_structure ,Case-Control Studies ,Immunology ,Female ,030211 gastroenterology & hepatology ,business ,HLA-DRB1 Chains - Abstract
Background and aims Autoimmune hepatitis (AIH) is a chronic liver disease that regularly relapses when immunosuppression is tapered. It is thought to be driven by T-cells, whereas the etiologic impact of an apparently deregulated B lineage system, as evidenced by hypergammaglobulinemia and autoantibodies, remains elusive. We set out to investigate T and B cell repertoires supporting chronic inflammation in AIH. Approach and results T and B cell receptor (TCR/BCR) and human leukocyte antigen (HLA) next-generation immunosequencing were used to record immune signatures from a cohort of 60 patients with AIH and disease controls. Blood and liver B lineage immune metrics were not indicative of a dominant directional antigen selection apart from a slight skewing of IGHV-J genes. More importantly, we found strong AIH-specific TRBV-J skewing not attributable to the HLA-DRB1 specificities of the cohort. This TCR repertoire bias was generated as a result of peripheral T cell (de)selection and persisted in disease remission. Using a clustering algorithm according to antigenic specificity, we identified liver TCR clusters that were shared between patients with AIH but were absent or deselected in patients with other liver pathologies. Conclusions Patients with AIH show profound and persisting T-cell architectural changes that may explain high relapse rates after tapering immunosuppression. Liver T-cell clusters shared between patients may mediate liver damage and warrant further study.
- Published
- 2021
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