TCR repertoire analysis by next generation sequencing allows complex differential diagnosis of T cell-related pathology

Am J Transplant. 2013 Nov;13(11):2842-54. doi: 10.1111/ajt.12431. Epub 2013 Sep 10.

Abstract

Clonotype analysis is essential for complete characterization of antigen-specific T cells. Moreover, knowledge on clonal identity allows tracking of antigen-specific T cells in whole blood and tissue infiltrates and can provide information on antigenic specificity. Here, we developed a next generation sequencing (NGS)-based platform for the highly quantitative clonotype characterization of T cells and determined requirements for the unbiased characterization of the input material (DNA, RNA, ex vivo derived or cell culture expanded T cells). Thereafter we performed T cell receptor (TCR) repertoire analysis of various specimens in clinical settings including cytomegalovirus (CMV), polyomavirus BK (BKV) reactivation and acute cellular allograft rejection. Our results revealed dynamic nature of virus-specific T cell clonotypes; CMV reactivation was linked to appearance of new highly abundant antigen-specific clonalities. Moreover, analysis of clonotype overlap between BKV-, alloantigen-specific T cell-, kidney allograft- and urine-derived lymphocytes provided hints for the differential diagnosis of allograft dysfunction and enabled appropriate therapy adjustment. We believe that the established approach will provide insights into the regulation of virus-specific/anti-tumor immunity and has high diagnostic potential in the clinical routine.

Keywords: Acute cellular rejection; BKV; differential diagnosis; kidney transplantation; next generation sequencing; polyoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • BK Virus / genetics
  • Cytomegalovirus / immunology*
  • Cytomegalovirus / pathogenicity
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / genetics
  • Cytomegalovirus Infections / virology
  • Diagnosis, Differential
  • Graft Rejection / genetics*
  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Kidney Transplantation / adverse effects
  • Polyomavirus Infections / diagnosis*
  • Polyomavirus Infections / genetics
  • Polyomavirus Infections / virology
  • Receptors, Antigen, T-Cell / genetics*
  • Retrospective Studies
  • T-Lymphocytes / immunology
  • T-Lymphocytes / pathology*
  • T-Lymphocytes / virology
  • Tumor Virus Infections / diagnosis*
  • Tumor Virus Infections / genetics
  • Tumor Virus Infections / virology
  • Virus Activation

Substances

  • Receptors, Antigen, T-Cell