Increased utilization of the VH6 gene family in patients with autoimmune idiopathic thrombocytopenic purpura.

The VH gene family utilization pattern among pokeweed mitogen-stimulated immunocompetent B cells (available repertoire) and naturally activated B cells (actual repertoire) from the spleen was analysed in a group of patients with autoimmune idiopathic thrombocytopenic purpura (AITP). For this purpose a non-radioactive RNA in situ hybridization technique was employed, allowing detection of VH gene family expression in single cells. The results show that the VH gene family expression pattern in patients with AITP does not correlate with genomic complexity of the VH genes. Furthermore, the pattern of VH gene family utilization in AITP patients is statistically different from that of healthy controls in the available, but not in the actual repertoire. The VH5 gene family is used at a frequency of 11.3% in patients' resting B lymphocytes, compared to 23.9% in controls. The VH6 gene family is used more frequently in patients (23.0% compared to 3.8% in controls). The increase in VH6 gene expression is not reflected in the actual repertoire, where the frequency of expression is 6.4%, and can therefore not be directly related to the presence of disease specific autoantibodies.