Multiple sclerosis is an autoimmune disease that is caused by the interplay of genetic, particularly the HLA-DR15 haplotype, and environmental risk factors. How these etiologic factors contribute to generating an autoreactive CD4+ T cell repertoire is not clear. Here, we demonstrate that self-reactivity, defined as "autoproliferation" of peripheral Th1 cells, is elevated in patients carrying the HLA-DR15 haplotype. Autoproliferation is mediated by memory B cells in a HLA-DR-dependent manner. Depletion of B cells in vitro and therapeutically in vivo by anti-CD20 effectively reduces T cell autoproliferation. T cell receptor deep sequencing showed that in vitro autoproliferating T cells are enriched for brain-homing T cells. Using an unbiased epitope discovery approach, we identified RASGRP2 as target autoantigen that is expressed in the brain and B cells. These findings will be instrumental to address important questions regarding pathogenic B-T cell interactions in multiple sclerosis and possibly also to develop novel therapies.
Journal article
2018-09-20T00:00:00+00:00
175
85 - 100.e23
B cells, HLA-DR15, RASGRP2, T cell receptor, T cells, autoproliferation, brain, multiple sclerosis, pathogenesis, Autoantigens, Autoimmune Diseases, B-Lymphocytes, Brain, CD4-Positive T-Lymphocytes, Guanine Nucleotide Exchange Factors, HLA-DR Serological Subtypes, Humans, Multiple Sclerosis, Receptors, Antigen, T-Cell, Th1 Cells