DOP47 Identification and characterization of T-cell receptor sequences associated with Crohn’s Disease

Pesesky, M.(1);Carty, C.L.(1);Singh, N.(2);Le Bourhis, L.(3);Rosati, E.(4);Bokemeyer, B.(5);Schreiber, S.(4);Görg, S.(6);Gittelman, R.M.(1);Dines, J.N.(2);Kaplan, I.M.(7);Zahid, H.J.(8);Baldo, L.(2);Snyder, T.M.(1);Robins, H.S.(1);Franke, A.(4);Allez, M.(3);

(1)Adaptive Biotechnologies, Innovation, Seattle, United States;(2)Adaptive Biotechnologies, Medical Affairs and Clinical Development, Seattle, United States;(3)Hôpital Saint-Louis, Hepato-Gastero-Enterologie, Paris, France;(4)Christian-Albrecht University of Kiel, Institute of Clinical Molecular Biology, Kiel, Germany;(5)Interdisciplinary Crohn Colitis Centre Minden, Crohn Colitis, Minden, Germany;(6)University Hospital of Schleswig-Holstein, Institute for Transfusion Medicine, Kiel, Germany;(7)Adaptive Biotechnologies, Partnerships, Seattle, United States;(8)Microsoft Research, Immunomics, Redmond, United States;

Background

T cells, as part of the adaptive immune system, are a significant driver of inflammation in Crohn’s disease (CD), yet specific T-cell targets are largely unknown. Genetic factors contribute to a small portion of CD risk including several HLA alleles, such as DRB1*07:01 and HLA-DRB1*01:03, associated with CD. The involvement of HLAs suggests that studying specific T cells could lead to new insights into CD development and progression. In this study, we use established immunoSEQ® technology to profile T-cell receptors (TCRs) and identify TCRs associated with CD and CD characteristics.

Methods

We analyzed TCRs from blood of 1,738 CD cases and 4,970 healthy controls. TCRs that were statistically enriched in cases, but not healthy controls (p <0.001), were termed Enhanced Sequences (ES) associated with CD. An independent cohort of 434 CD cases was used for validation. We inferred associations between the ES and 145 common HLA alleles using data from a separate, HLA-typed dataset. We defined ES clusters by correlating TCRs with single amino acid substitutions.

Results

We identified 1,121 CD-associated ES in the exploratory cohort. These were also enriched in CD cases in our validation cohort (Fig 1A). Using intestinal tissue samples from a subset of cases, we found that a median of 14% ES from individual cases were shared between blood and tissue samples (Fig. 1B). ES breadth (ES diversity relative to total TCR diversity) was significantly associated with history of CD-related surgery (Fig 1C, p < 1x10-15), with stricturing or fistulizing phenotypes (Fig 1D, p < 1x10-5 for B1 versus B2 or B3), and with ileal or ileocolonic location (Fig 1E, p < 1x10-7 for L2 versus L1 or L3).

We found that 202 ES formed clusters of similar sequences consisting of 2-23 members (Fig. 2A). We confidently (p < 0.0001) associated 398 ES to a specific HLA allele (Fig 2B), including 134 of the ES assigned to clusters (Fig 2A). Some clusters, including the largest, had no members that could be assigned to an HLA allele, raising the possibility that these ES clusters bind non-canonical HLAs.

Conclusion

Our discovery set of public TCRs associated with CD indicates that the immune system of CD patients responds to a consistent set of antigens. Importantly, CD ES were present in both tissue and blood, demonstrating that evaluating TCRs in blood may be a surrogate of TCRs in tissue. The HLA allele associations of these ES potentially point to new risk factors and disease insights, such as the involvement of DP and DQ alleles. The association of ES frequency with CD characteristics strongly suggested that further examination of these TCRs may impact CD patient care and advance understanding of the pathophysiology of the disease.