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Sural nerve T-cell receptor Vß gene utilization in chronic inflammatory demyelinating polyneuropathy and vasculitic neuropathy

From the Department of Neurology of the Rudolf Magnus Institute for Neurosciences (Drs. Bosboom, Van den Berg, and Wokke, I. Mollee, L.D. Sasker, and J. Jansen); and the Department of Immunology (T. Logtenberg), University Medical Center Utrecht, the Netherlands.

Address correspondence and reprint requests to Dr. Leonard H. van den Berg, Department of Neurology, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, the Netherlands; e-mail: l.h.vandenberg{at}neuro.azu.nl

Objective: To investigate the utilization of T-cell receptor (TCR) variable (V) regions in infiltrates of sural nerve biopsies of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and vasculitic neuropathy. Background: The presence of infiltrating T lymphocytes in sural nerve biopsies may suggest a T cell-mediated immune mechanism in the pathogenesis of CIDP and vasculitic neuropathy. Patients and methods: The utilization of TCR Vß regions in sural nerves of 13 patients with CIDP and five patients with vasculitic neuropathy was determined by immunohistochemistry, reverse-transcription PCR, and nucleotide sequence analysis. These techniques were also applied in four patients with chronic idiopathic axonal polyneuropathy (CIAP) who acted as noninflammatory controls, and in five autopsy controls. Results: The TCR Vß utilization of infiltrating T cells in sural nerves of patients with CIDP, vasculitic neuropathy, and noninflammatory controls is heterogeneous. A dominant TCR Vß utilization was not found in any of the patients or controls. Conclusion: There is no evidence for the presence of clonally expanded T cells in sural nerves of patients with CIDP and vasculitic neuropathy.

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