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Breaking the rules: the unconventional recognition of HLA-B27 by CD4+ T lymphocytes as an insight into the pathogenesis of the spondyloarthropathies Boyle LH; Hill Gaston JSRheumatology (Oxford) 2003[Mar]; 42 (3): 404-12Despite extensive research, it remains unclear why a small proportion of HLA- B27(+) individuals develop spondyloarthropathies (SpA). Because the function of HLA-B27, as a major histocompatibility complex (MHC) class I molecule, is peptide presentation to CD8(+) T cells, research has concentrated on the role of HLA-B27 as a restriction element for CD8(+) cytotoxic T lymphocytes in pathogenesis. However, findings in the B27-transgenic animal models, together with the identification of unusual processing and presentation features of HLA-B27, have raised alternative hypotheses for the pathogenic role of HLA-B27. One such hypothesis is that HLA-B27 can be recognized by CD4(+) T lymphocytes. Here we report the identification of such unusual cells, which break the conventional rules of MHC restriction, and propose a model for the role of such CD4(+) T cells in SpA.|Animals[MESH]|CD4-Positive T-Lymphocytes/*immunology[MESH]|Disease Models, Animal[MESH]|HLA-B27 Antigen/*immunology[MESH]|Humans[MESH]|Spondylarthropathies/*immunology[MESH]|Structure-Activity Relationship[MESH] |
