Single Cell Sequencing Suggests Mucosal Origins of T Cells in HLA-B27-associated Inflammation

Abstract HLA-B27 was one of the first Major Histocompatibility Complex alleles associated with an autoimmune disease, i.e., Ankylosing Spondylitis (AS) and acute anterior uveitis (B27AU), which cause joint and eye inflammation, respectively. As HLA-B27 presents antigens to CD8 T cells, an antigen-specific CD8 T cell response may be central to disease pathogenesis. Consistent with this hypothesis, our recent work identified clonal expansion of public T cell receptors (TCRs) shared across patients with AS and B27AU and enriched in the joint or eye over the blood. These TCRs recognized both bacterial and self-peptides, suggesting a role for molecular mimicry in multiple organs afflicted by HLA-B27-associated inflammation. The main bacterial peptide recognized by these public TCRs is derived from yeiH, a gene present in multiple enteric microbiota. It remains unclear, however, whether these T cells have had a prior antigenic encounter within the gastrointestinal tract. We therefore performed single-cell RNA sequencing (scRNAseq) and T cell receptor sequencing (scTCRseq) on immune cells from the eye and blood during B27AU (n=5) and non-B27AU (n=14). In this analysis, we found that the expanded TCRs in B27AU were associated with CD161 expression and enriched for a transcriptional program from intestinal CD8 T cells. Moreover, we were able to identify an additional expanded TCR sequence that also recognized YEIH. Finally, expanded T cell clones contained higher expression of TNFand IFNG, suggestive of a pro-inflammatory transcriptional program. Collectively, our data suggest that, in HLA-B27-associated inflammation, the early antigen exposure and differentiation of putative pathogenic CD8 T cells may have occurred in enteric organs. This study received support from NIH 5R01AI103867 (KCG), U19AI057229 (KCG), the Howard Hughes Medical Institute (KCG), the Rheumatology Research Foundation (MAP), Arthritis National Research Foundation (MAP), the Rheumatic Diseases Research Resource-based Center at Washington University (NIH P30-AR073752, MAP, WMY), the Bursky Center for Human Immunology and Immunotherapy Programs (WMY), and the Barnes-Jewish Hospital Foundation (WMY).