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. 2025 Jan 21;219(1):uxae102.
doi: 10.1093/cei/uxae102.

Antigen-specific T-cell frequency and phenotype mirrors disease activity in DRB1*04:04+ rheumatoid arthritis patients

Cliff Rims  1 , Hannes Uchtenhagen  1 , Kadin Brooks  1 , Bernard Ng  2   3 , Sylvia E Posso  1 , Jeffrey Carlin  4 , William W Kwok  1 , Jane H Buckner  1 , Eddie A James  1
Affiliations

Antigen-specific T-cell frequency and phenotype mirrors disease activity in DRB1*04:04+ rheumatoid arthritis patients

Cliff Rims et al. Clin Exp Immunol. .

Abstract

Rheumatoid arthritis (RA) is associated with high-risk HLA class II alleles known as the "RA shared epitope." Among prevalent shared epitope alleles, study of DRB1*04:04 has been limited. To define relevant epitopes, we identified citrullinated peptide sequences from synovial antigens that were predicted to bind to HLA-DRB1*04:04 and utilized a systematic approach to confirm their binding and assess their recognition by CD4 T cells. After confirming the immunogenicity of 13 peptides derived from aggrecan, cartilage intermediate layer protein (CILP), α-enolase, vimentin, and fibrinogen, we assessed their recognition by T cells from a synovial tissue sample, observing measurable responses to 8 of the 13 peptides. We then implemented a multicolor tetramer panel to evaluate the frequency and phenotype of antigen-specific CD4 T cells in individuals with anti-citrullinated protein antibody-positive RA and controls. In subjects with RA, CILP-specific T-cell frequencies were significantly higher than those of other antigens. The surface phenotypes exhibited by antigen-specific T cells were heterogeneous, but Th1-like and Th2-like cells predominated. Stratifying based on disease status and activity, antigen-specific T cells were more frequent and most strongly polarized in RA subjects with high disease activity. In total, these findings identify novel citrullinated epitopes that can be used to interrogate antigen-specific CD4 T cells and show that antigen-specific T-cell frequency is elevated in subjects with high disease activity.

Keywords: T cell; autoimmunity; citrulline; disease activiry; rheumatoid arthritis; shared epitope.

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Conflict of interest statement

EAJ has two joint patents on Factor VIII epitopes with BloodWorks Northwest and has past and current research projects sponsored by Pfizer, Janssen, Sanofi, Bristol-Myers Squibb, Nipuna Therapeutics, and Novartis. JHB is President of the Benaroya Research Institute at Virginia Mason, is a Scientific Co-Founder and Scientific Advisory Board member of GentiBio, is a consultant for Bristol-Myers Squibb, and has past and current research projects sponsored by Amgen, Bristol-Myers Squib, Janssen, Novo Nordisk, and Pfizer. JHB also has a patent on methods of generating antigen-specific CD4+CD25+ Tregs. The remaining authors have declared no conflict of interest exists.

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