TY - JOUR A1 - Ritter, Julia A1 - Zimmermann, Karin A1 - Jöhrens, Korinna A1 - Mende, Stefanie A1 - Seegebarth, Anke A1 - Siegmund, Britta A1 - Hennig, Steffen A1 - Todorova, Kremena A1 - Rosenwald, Andreas A1 - Daum, Severin A1 - Hummel, Michael A1 - Schumann, Michael T1 - T-cell repertoires in refractory coeliac disease JF - Gut N2 - Objective Refractory coeliac disease (RCD) is a potentially hazardous complication of coeliac disease (CD). In contrast to RCD type I, RCD type II is a precursor entity of enteropathy-associated T-cell lymphoma (EATL), which is associated with clonally expanding T-cells that are also found in the sequentially developing EATL. Using high-throughput sequencing (HTS), we aimed to establish the small-intestinal T-cell repertoire (TCR) in CD and RCD to unravel the role of distinct T-cell clonotypes in RCD pathogenesis. Design DNA extracted from duodenal mucosa specimens of controls (n=9), active coeliacs (n=10), coeliacs on a gluten-free diet (n=9), RCD type I (n= 8), RCD type II (n= 8) and unclassified Marsh I cases (n= 3) collected from 2002 to 2013 was examined by TCR beta-complementarity- determining regions 3 (CDR3) multiplex PCR followed by HTS of the amplicons. Results On average, 106 sequence reads per sample were generated consisting of up to 900 individual TCR beta rearrangements. In RCD type II, the most frequent clonotypes (ie, sequence reads with identical CDR3) represent in average 42.6% of all TCR beta rearrangements, which was significantly higher than in controls (6.8%; p<0.01) or RCD type I (6.7%; p<0.01). Repeat endoscopies in individual patients revealed stability of clonotypes for up to several years without clinical symptoms of EATL. Dominant clonotypes identified in individual patients with RCD type II were unique and not related between patients. CD-associated, gliad-independent CDR3 motifs were only detectable at low frequencies. Conclusions TCR beta-HTS analysis unravels the TCR in CD and allows detailed analysis of individual TCR beta rearrangements. Dominant TCR beta sequences identified in patients with RCD type II are unique and not homologous to known gliadin-specific TCR sequences, supporting the assumption that these clonal T-cells expand independent of gluten stimulation. KW - Intestinal Intraepithelial Lymphocy KW - Delta Repertoire KW - Lymphoma KW - Usage KW - Clonality KW - Sprue KW - Chains KW - Design KW - Epitope KW - Frequency Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-226350 VL - 67 IS - 4 ER - TY - THES A1 - Gahn, Carolin T1 - Die Häufigkeiten der Mutationstypen und deren Verteilung im Dystrophin-Gen T1 - The Frequency of the Mutation Types and their Distribution in the Dystrophin Gene N2 - Die progressiven Muskeldystrophien Duchenne (DMD) und Becker (BMD) entstehen durch verschiedene Mutationstypen (Deletionen, Duplikationen, Punktmutationen) im Dystrophin-Gen, welches als größtes Gen des Menschen 79 Exons aufweist und sich auf dem kurzen Arm des X-Chromosoms befindet. Es wurden Daten von 1365 Personen bezüglich der Häufigkeit der Mutationstypen sowie der Verteilung der einzelnen Mutationen auf die Exons des Dystrophin-Gens ausgewertet. Hieraus konnte ermittelt werden, dass sich bei 780 männlichen Patienten mit gesicherter Diagnose zu 65 Prozent Deletionen, 9 Prozent Duplikationen und 26 Prozent Punktmutationen nachweisen ließen. Desweiteren wurde gezeigt, dass sich bei der Verteilung der Deletionen auf das Dystrophin-Gen zwei hot spot Regionen finden, eine größere im Bereich der Exons 45 - 54 und eine kleinere im Bereich 11 - 20. Die Duplikationen weisen eine Häufung der betroffenen Exons am Anfang des Gens auf, wobei Exon 2 am häufigsten das erste betroffene Exon darstellt. Die Punktmutationen dagegen verteilen sich zufällig über das Gen. Es konnte weiterhin gezeigt werden, dass hinsichtlich der Verteilung der gleichen Mutationen auf das Dystrophin-Gen zwischen einer Gruppe von männlichen Patienten und der Gesamtheit aller Probanden einschließlich Konduktorinnen keine Unterschiede bestehen. Dagegen unterschieden sich die verschiedenen Mutationstypen im Vergleich miteinander hinsichtlich ihrer Verteilung auf das Dystrophin-Gen. Bei der Untersuchung der geographischen Verteilung der DMD und BMD konnte lediglich bei den Duplikationen eine Gleichverteilung in Deutschland bestätigt werden. N2 - The progressive muscular dystrophies Duchenne (DMD) and Becker (BMD) originate from different mutation types (deletions, duplications, point mutations) in the dystrophin gene, the biggest human gene, which has 79 exons and is located on the short arm of the X-chromosome. Data of 1365 people were evaluated with regard to the frequency of the mutation types as well as the distribution of mutations over the exons of the dystrophin gene. We found that in 780 male patients with secured diagnosis, there were deletions in 65 percent of the cases, duplications in 9 percent and point mutations in 26 percent. Furthermore it was shown that the distribution of deletions in the dystrophin gene shows two hot spot regions, a larger one in the area of exons 45 - 54 and a smaller one in the area of exons 11 - 20. Duplications showed an accumulation of affected exons at the beginning of the gene, with exon 2 being the first affected exon most often. Point mutations in contrast are distributed over the gene randomly. Moreover it was found out that the distribution of mutations in the dystrophin gene did not differ between a group of male patients and the group of all patients including female carriers, whereas mutation types differed regarding their dissemination over the dystrophin gene. With the analysis of the geographic distribution of DMD and BMD a uniform geographical distribution over Germany could be confirmed merely with duplications. KW - Muskeldystrophie KW - Duchenne KW - Dystrophin-Gen KW - Mutation KW - Verteilung KW - Muskeldystrophie KW - Duchenne KW - Dystrophin-Gen KW - Mutation KW - Verteilung KW - Muscular Dystrophy KW - Duchenne KW - Dystrophin Gene KW - Mutation KW - Frequency Y1 - 2010 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-56490 ER -