Because TCR is the key to initiate T cell reactions, studying TCR in OMDT may help to clarify the underlying pathogenetic mechanism and provide basis for more effective prevention and treatment measures.Įach T cell is known to generally encode one single, unique TCR. T cell receptor (TCR) is a membrane protein of T cell responsible for recognizing antigens and transmitting signals to downstream molecules 6. Therefore, T cells may play a pivotal role in the pathogenesis of OMDT. Other pathological evidence includes that elevated levels of T cells were identified in peripheral blood and affected skin tissues of the patients 5. Based on the above features, OMDT is generally regarded as a T cell-mediated, Type IV hypersensitivity reaction. The clinical features of OMDT include a latency of 2–5 weeks, no dose–response relationship, skin lesions not confined to the contact area, the relatively effective glucocorticoid therapy, and rapid recurrence due to re-exposure to trichloroethylene 2, 4. Survived patients usually had a very long clinical course, and the symptoms could relapse after cessation of the treatment. Epidemiological studies predicted that the incidence of OMDT was about 1% 2, but more than 7% of the patients died of secondary hepatic encephalopathy, severe infection, and multiple organ failure 3. It resembles serious drug hypersensitivities referred to as drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity syndrome (DIHS) 2. The manifestation of OMDT includes various degrees of generalized skin lesions, fever, hepatitis, and lymphadenopathy. Exposure to TCE was reported to cause a notorious occupational disease named occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT). Trichloroethylene (TCE) is known as an environmental contaminant and an industrial toxicant mainly used as organic solvent and degreasing agent, mostly in some Asian countries like China, Japan and Korea over the last few decades 1, 2. We revealed further how TCR repertoires vary with the severity in the development of OMDT, and severity-related TCRs may provide important therapeutic targets for OMDT in clinical practice. Ten CDR3-nt and 7 CDR3-aa sequences in TRBV7-9-TRBJ2-1 combination and 1 CDR3-nt and 1 CDR3-aa sequences in TRBV6-4-TRBJ2-1 combination were identified as associated with the severity of OMDT (all P < 0.001). TRBV6-4 combination with TRBJ2-1, TRBJ2-2, TRBJ2-3, and TRBJ2-6, and TRBV7-9 combination with TRBJ2-1 were associated with the stage by OMDT severity (all P < 0.001). TRBV6-4 and TRBV7-9 frequencies significantly differed between the cases and controls (both P < 6.1 × 10 –4). The TCR repertoire diversity, TRBV/TRBD/TRBJ gene usage and combination, frequencies of CDR3 nucleotide (nt) and amino acid (aa) sequences in the cases in different stages and in the controls were analyzed. Peripheral blood TCR β-chain complementarity-determining region 3 (CDR3) genes were detected with the high throughput sequencing in 24 OMDT cases in their acute, chronic and recovery stages, respectively, and in 24 trichloroethylene-exposed healthy controls. Previously, we had cross-sectionally explored the characteristics of T cell receptor (TCR) repertoires from occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT) patients, now we further analyzed the dynamic features of OMDT TCR repertoires.
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