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. 1999 Jul;58(7):435–440. doi: 10.1136/ard.58.7.435

Ankylosing spondylitis in monozygotic twins: studies on immunological parameters

T Hohler 1, R Hug 1, P Schneider 1, F Krummenauer 1, C Gripenberg-Lerche 1, K Granfors 1, E Marker-Hermann 1
PMCID: PMC1752907  PMID: 10381488

Abstract

OBJECTIVE—To examine immunological parameters that might explain disease discordance in monozygotic twin pairs with ankylosing spondylitis (AS).
METHODS—11 monozygotic twin pairs (nine with AS, two with undifferentiated spondyloarthropathy) were investigated. The peripheral T cell receptor Vβ repertoire was investigated using FACS analysis and 14 different Vβ antibodies. In addition serum samples were tested for antibodies to Klebsiella pneumoniae, Streptococcus pyogenes, Candida albicans, Proteus mirabilis, and Escherichia coli. Peripheral blood lymphocyte reactivity against a number of bacteria was investigated by interferon γ ELISPOT assays.
RESULTS—Twins suffering from AS showed cellular hyporeactivity against K pneumoniae, S pyogenes, C albicans in the ELISPOT assays compared with healthy twins. In contrast with the antibody data, where no significant differences were observed between the two groups, AS concordant twins showed the most pronounced differences in their Vβ repertoire on CD4+ and CD8+ lymphocytes.
CONCLUSIONS—Cellular hyporeactivity of peripheral blood cells to bacterial antigens might reflect defective T cell responses allowing bacterial antigens to persist in diseased patients. There are probably other environmental factors that influence disease concordance.



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Figure 1  .

Figure 1  

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Differences in Vβ repertoire in CD4+ and CD8+ T lymphocytes in the different study groups. Concordant twin pairs are shown in black, discordant twins in white and the healthy twins in grey. The y axis gives the percentage of significant differences in the Vβ repertoire in relation to the number of comparisions made. Significant differences were observed in 28 of 56 comparisons (50%) for CD4+ T cells in concordant twins (4 concordant twin pairs, 14 Vβ families tested) compared with 27 of 98 comparisons (27.5%) between discordant twins (7 discordant twin pairs, 14 Vβ families tested; p<0.005).

Figure 2  .

Figure 2  

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Results of the IFNγ ELISPOT assays. Twins with AS and uSpA are shown in black, unaffected co-twins in grey.

Figure 3  .

Figure 3  

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Titres of selected anti-klebsiella antibodies in the serum samples of the patients. Twins with AS and uSpA are shown in black, unaffected co-twins in grey.

Selected References

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