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The canonical function of HLA-B27 is to present antigenic peptides to CD8 lymphocytes, leading to adaptive immune responses. The \u2018arthritogenic peptide\u2019 theory as to the mechanism by which HLA-B27 induces ankylosing spondylitis proposes that HLA-B27 presents peptides derived from exogenous sources such as bacteria to CD8 lymphocytes, which subsequently cross-react with antigens at the site of inflammation of the disease, causing inflammation. This review describes findings of studies in AS involving profiling of T cell expansions and discusses future research opportunities based on these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Recent Findings<\/jats:title><jats:p>Consistent with this theory, there is an expanding body of data showing that expansion of a restricted pool of CD8 lymphocytes is found in most AS patients yet only in a small proportion of healthy HLA-B27 carriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Summary<\/jats:title><jats:p>These exciting findings strongly support the theory that AS is driven by presentation of antigenic peptides to the adaptive immune system by HLA-B27. They point to new potential approaches to identify the exogenous and endogenous antigens involved and to potential therapies for the disease.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s11926-022-01090-6","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T08:02:46Z","timestamp":1664956966000},"page":"398-410","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["T cell Repertoire Profiling and the Mechanism by which HLA-B27 Causes Ankylosing Spondylitis"],"prefix":"10.1007","volume":"24","author":[{"given":"Jose","family":"Garrido-Mesa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0538-8211","authenticated-orcid":false,"given":"Matthew A.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"issue":"4","key":"1090_CR1","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1093\/rheumatology\/ket387","volume":"53","author":"LE Dean","year":"2014","unstructured":"Dean LE, Jones GT, MacDonald AG, Downham C, Sturrock RD, Macfarlane GJ. 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