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© 1996 British Society for Rheumatology

research-article

ANTIGEN-PRESENTING CELLS BUT NOT LYMPHOCYTES IN THE JOINT MAY INDICATE THE CAUSE OF REACTIVE ARTHRITIS

A. J. STAGG, R. A. HUGHES*, A. C. S. KEAT{dagger}, W. A. J. ELSLEY and S. C. KNIGHT

Antigen Presentation Research Group, Imperial College School of Medicine, Northwick Park Institute for Medical Research Harrow HA1 3UJ
*RheumatologyDepartment, St Peter'sHospital ChertseyKT160PX
{dagger}Rheumatology Department, Northwick Park Hospital Harrow HA I 3UJ

Correspondence to: Correspondence to: A. J. Stagg, Antigen Presentation Research Group, Impenal College School of Medicine, Northwick Park Institute for Medical Research, Watford Road, Harrow HAl 3UJ

T cells and antigen-presenting cells (APQ accumulate in the joint in reactive arthritis and there are reports that the T cells are a population selected for responsiveness to the causative agent. In this work, the latter view is questioned by detailed studies of the antigen specificities of the lymphocytes within the joint (SFMQ and peripheral blood (PBMQ of patients with reactive arthritis triggered by infection with Chlamydia trachomatis. Using a hanging-drop microculture system, SFMC displayed enhanced responses not only to antigens from the triggering organism, but also to other antigens, including PPD and tetanus toxoid, to which the patients were likely to have had prior exposure. No evidence was obtained for a dominant cross-reactive T-cell response to epitopes common to these antigen preparations, confirming the polyclonal nature of the infiltrate. In contrast to the broad specificity of the T-cell infiltrate, two experimental approaches indicated that APC within the joint carried chlamydial antigen. The failure of antigen-bearing APC to interact with T cells at this site may underlie the inability to clear microbial antigen from the joint.

KEY WORDS: Reactive arthritis, Antigen-presenting cells, Dendritic cells, T cells


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