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The anti-rheumatoid drug D-penicillamine (D-pen) has a reactive sulfhydryl group capable of modifying self antigens, and can provoke typical autoantibody-mediated myasthenia gravis (MG), especially in DR1+ individuals. We have selected T cell clones from one such patient that were highly specific for D-pen but not its L-isomer or D-cysteine. Moreover, they were restricted to HLA-DR1, had a Th1 phenotype and used TCR V alpha4.1, V beta6.1. They responded well to blood mononuclear cells prepulsed with D-pen either in the absence of serum or after chloroquine treatment, but not to autologous D-pen-pulsed B cell lines. Thus, D-pen may directly couple to distinctive peptides resident in surface DR1 molecules on circulating macrophages or dendritic cells.


Journal article


J Neuroimmunol

Publication Date





146 - 153


Aged, Amino Acid Sequence, Antirheumatic Agents, Autoimmune Diseases, Base Sequence, Blood Proteins, CD3 Complex, CD4-Positive T-Lymphocytes, Cell Line, Chloroquine, Drug Hypersensitivity, Epitopes, Female, HLA-DR1 Antigen, Histocompatibility Antigens Class II, Humans, Molecular Sequence Data, Myasthenia Gravis, Penicillamine, Protein Binding, Receptors, Antigen, T-Cell, alpha-beta, Thymidine, Tritium