Extended reports
Ankylosing spondylitis in monozygotic twins: studies on
immunological parameters
Thomas Höhlera, Rosula Huga, Peter M Schneiderb, Frank Krummenauerc, Christel Gripenberg-Lerched, Kaisa Granforsd, Elisabeth Märker-Hermanna
a Medical Department
of Internal Medicine, Johannes Gutenberg Universität Mainz, Mainz,
Germany, b Institute of Legal Medicine, Mainz, Germany, c Institute of Medical
Statistics and Documentation, Mainz, Germany, d National
Public Health Institute, Department in Turku, Turku, Finland
Correspondence to: Dr T Höhler, I Medizinische Klinik und Poliklinik, Johannes Gutenberg-Universität Mainz, Langenbeckstr 1, 55101 Mainz, Germany.
Accepted for publication 9 March 1999
OBJECTIVE
To examine
immunological parameters that might explain disease discordance in
monozygotic twin pairs with ankylosing spondylitis (AS).
METHODS11 monozygotic
twin pairs (nine with AS, two with undifferentiated
spondyloarthropathy) were investigated. The peripheral T cell receptor
V
repertoire was investigated using FACS analysis and 14 different
V 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 
ELISPOT assays.
RESULTSTwins
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
V repertoire on CD4+ and CD8+ lymphocytes.
CONCLUSIONSCellular
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.
© 1999 by Annals of the Rheumatic Diseases
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