T cell receptor sharing in hypersensitivity pneumonitis

Abstract

Hypersensitivity pneumonitis (HP) is characterised by an excessive pulmonary T cell response in susceptible individuals after exposure to inhaled antigens. The most effective treatment for the condition is antigen avoidance, but in most cases an antigen cannot be identified. Profiling antigen-specific T cell responses may form the basis of a strategy to identify causative antigens of the disease. We used public RNA sequencing data and reconstructed T cell receptor (TCR) repertoires from blood and bronchoalveolar lavage samples from patients with HP, idiopathic pulmonary fibrosis and healthy controls. After excluding TCR sequences likely to be related to common microbial exposures in patients with HP, we identified TCRs shared between patients with shared human leukocyte antigen alleles, indicating patients likely to have a common causative antigen. We also identified clusters of TCRs containing identical and similar TCR clones in individual patients that are plausibly related to the causative antigens in those patients. These results establish the feasibility of profiling TCR repertoires to identify antigens in HP.