A pathogenetic role for the thymoma in myasthenia gravis. Autosensitization of IL-4- producing T cell clones recognizing extracellular acetylcholine receptor epitopes presented by minority class II isotypes

J Clin Invest. 1998 May 15;101(10):2268-77. doi: 10.1172/JCI2068.

Abstract

Myasthenia gravis (MG) is caused by helper T cell-dependent autoantibodies against the muscle acetylcholine receptor (AChR). Thymic epithelial tumors (thymomas) occur in 10% of MG patients, but their autoimmunizing potential is unclear. They express mRNAs encoding AChR alpha and epsilon subunits, and might aberrantly select or sensitize developing thymocytes or recirculating peripheral T cells against AChR epitopes. Alternatively, there could be defective self-tolerance induction in the abundant maturing thymocytes that they usually generate. For the first time, we have isolated and characterized AChR-specific T cell clones from two MG thymomas. They recognize extracellular epitopes (alpha75-90 and alpha149-158) which are processed very efficiently from muscle AChR. Both clones express CD4 and CD8alpha, and have a Th-0 cytokine profile, producing IL-4 as well as IFN-gamma. They are restricted to HLA-DP14 and DR52a; expression of these minority isotypes was strong on professional antigen-presenting cells in the donors' tumors, although it is generally weak in the periphery. The two clones' T cell receptor beta chains are different, but their alpha chain sequences are very similar. These resemblances, and the striking contrasts with T cells previously cloned from non-thymoma patients, show that thymomas generate and actively induce specific T cells rather than merely failing to tolerize them against self antigens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Sequence
  • Antigen-Presenting Cells / immunology
  • Antigens, CD / immunology
  • Autoimmunity / immunology
  • Clone Cells / immunology
  • Epitope Mapping
  • Flow Cytometry
  • Histocompatibility Antigens Class II / immunology
  • Humans
  • Immunohistochemistry
  • Interferon-gamma / metabolism
  • Interleukin-4 / metabolism*
  • Molecular Sequence Data
  • Myasthenia Gravis / immunology*
  • Receptors, Antigen, T-Cell / chemistry
  • Receptors, Cholinergic / chemistry
  • Receptors, Cholinergic / immunology*
  • Sequence Analysis, DNA
  • T-Lymphocytes, Helper-Inducer / immunology*
  • Thymoma / immunology
  • Thymoma / physiopathology*

Substances

  • Antigens, CD
  • Histocompatibility Antigens Class II
  • Receptors, Antigen, T-Cell
  • Receptors, Cholinergic
  • Interleukin-4
  • Interferon-gamma