Gamma delta T cells infiltrating nerve biopsies from patients with inflammatory neuropathy

Sensory nerve biopsy specimens from patients with Guillain Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and controls consisting of other neuropathies, were examined in order to characterise the nature and intensity of any inflammatory infiltrate. In order to establish whether gamma delta T cells were present in these infiltrates we examined the expression of alpha beta and gamma delta T cell receptors in the biopsy specimens from patients with inflammatory neuropathy. A section of each biopsy specimen was simultaneously cultured in order to attempt to establish T cell lines. T cell lines were established in 4 out of 7 patients with GBS of which 2 were gamma delta in phenotype. There was a significant correlation between the number of mononuclear cells detected by immunostaining within the biopsy specimens and the chance of successfully establishing a T cell line. Histological studies detected gamma delta T cell receptor in 2 out of the 7 patients with GBS, 14 out of the 20 with CIDP and in 5 out of the 13 controls (vasculitis 3, paraneoplastic 1, axonal neuropathy of uncertain cause 1). The presence of T cells of a gamma delta T cell receptor phenotype in nerve biopsy specimens from patients with inflammatory neuropathy is consistent with a possible pathogenetic role of a cellular immune response against non-protein antigens such as gangliosides.