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Isabelle Marie, MD, PhD; Nadège Cordel, MD; Bernard Lenormand, MD; Marie-France Hellot, ScD; Hervé Levesque, MD, PhD; Hubert Courtois, MD, PhD; Pascal Joly, MD, PhD

Arch Dermatol. 2005;141:88-89.

Background  It has been suggested that clonal T cells may play a critical role in the pathogenesis of systemic sclerosis.

Observations  A monoclonal population of T cells was found in blood samples from 13 (34%) of 38 consecutive patients with a definite diagnosis of systemic sclerosis who were prospectively examined by T-cell receptor gene rearrangement using polymerase chain reaction analysis and denaturating gradient gel electrophoresis. In the healthy control group, the same type of examination revealed a monoclonal population of T cells in the blood samples from only 3 healthy subjects (4%)(odds ratio, 12.28; 95% confidence interval, 2.76-54.64; P = .001). Patients who had a circulating clonal population of T cells were older than those who did not (67 years vs 48 years; P = .04). There was a marked relationship between systemic sclerosis subtypes and the presence of a circulating clonal population of T cells. Twelve (43%) of 28 patients with limited cutaneous sclerosis exhibited a circulating clonal population of T cells, whereas only 1 (10%) of the 10 patients with diffuse cutanous sclerosis had evidence of T-cell clonality (P<.01).

Conclusions  Clonally expanded T cells were more commonly detected in patients with limited cutaneous sclerosis than in those with diffuse cutaneous sclerosis, which is also in accordance with a possible role of clonal T cells in patients with limited cutaneous sclerosis.

Author Affiliations: Department of Internal Medicine and INSERM Unit 644, Centre Hospitalier Universitaire de Rouen-Boisguillaume (Drs Marie, Levesque, and Courtois), and Departments of Dermatology (Drs Cordel and Joly), Hematology (Dr Lenormand), and Biostatistics (Dr Hellot), Centre Hospitalier Universitaire de Rouen, Rouen, France.

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