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Background:The recognition of allergenic peptides by T cells through their T-cell receptor (TCR) represents a crucial step in the initiation of an allergen-specific immune response. In parallel to the superantigen-driven restricted expansion of Vβ subsets in autoimmune and infectious diseases, reports in animals and human subjects have shown a similar capacity of classical antigens.Objective:The study was performed to analyze the Vα/Vβ expression in house dust mite (HDM) allergy.Methods:The TCR repertoire of 15 subjects with HDM allergy, 22 atopic subjects without HDM allergy, and 19 nonatopic individuals, members of 2 extended and 4 nuclear families, was determined. By using flow cytometry, the expression of 22 Vβ and 3 Vα elements was analyzed in vivo and after in vitro allergen stimulation.Results:In comparison with nonatopic and atopic individuals without HDM allergy, freshly isolated PBMCs of individuals with HDM allergy showed a significantly higher frequency of Vβ18+and Vα2.3+T cells. Although members of all 3 groups had a similar lymphocyte proliferation response after in vitro stimulation with Der p 1 or Der p 1 peptide101-131, a significant expansion of Vβ18+and Vα2.3+T cells in vitro occurred only in individuals with HDM allergy. Moreover, the degree of expansion correlated with the levels of allergen-specific IgE antibodies. No expansion of Vβ18+and Vα2.3+was observed after mitogen stimulation with PHA, indicating allergen specificity of the response.Conclusion:Our results strongly suggest restricted TCR Vα/Vβ gene use in HDM allergy and might be a step toward TCR-based immunotherapy. (J Allergy Clin Immunol 2002;109:517-23.)