Killer cell activating receptors function as costimulatory molecules on CD4+CD28null T cells clonally expanded in rheumatoid arthritis

Expansion of CD4(+)CD28(null) T cells is a characteristic finding in patients with rheumatoid arthritis, Despite lacking CD28 molecules, these unusual CD4 T cells undergo clonal proliferation and form large and long-lived clonal populations, They produce high levels of IFN-gamma, exhibit autoreactivity, and have cytolytic function. The mechanisms facilitating the expansion and longevity of CD4(+)CD28(null) T cell clones in vivo are unknown. Here, we report that CD4(+)CD28(null), but not CD4(+)CD28(+), T cells express MHC class I-recognizing receptors normally found on NK cells. CD4(+)CD28(null) T cells preferentially expressed killer cell activating receptors (KAR), often in the absence of killer cell inhibitory receptors, Cross-linking of KAR molecules enhanced the proliferative response to TCR-mediated stimulation, but not the cytolytic function of CD4(+)CD28(null) T cells, suggesting different signaling pathways in CD4 T cells and NK cells. Triggering of KAR signaling led to the phosphorylation of several cellular targets, although the pattern of phosphorylation differed from that induced by the TCR, Aberrant expression of KAR molecules in the absence of inhibitory receptors and in the appropriate HLA setting may lead to the clonal outgrowth of autoreactive CD4(+)CD28(null) T cells commonly seen in rheumatoid arthritis.