After multiple experimentations were done by using sophisticated equipment like PCR Tubes, it was revealed that during the early development stages of T-cell, the TCR gamma (TCRG) and the T-cell receptor, the rearrangements of TCR beta (TCRB) rearrangements get preceded. As a result of this, every mature T-cell malignancy is not just composed of TCRB rearrangements, but also contains immature or partially mature T-cell malignancies. A few examples of this condition are lymphoblastic leukaemias (ALL).
What is the internal composition of TCRB?
After multiple experimentation and research done by using various equipment such as Thin-wall PCR Tubes, the scientists found out that the gene cluster contains around 65 Vβ gene segments. The two of these 65 genes are Dβ-Jβ-Cβ regions which are composed of at least one Dβ gene segment (TCRBD1 and TCRBD2).
The entire process of rearrangement of the TCRB gene is initiated by the linkage of Dβ-Jβ. This further leads to a totally incomplete TCRB rearrangement. During the second step of rearrangement, there is an addition of the Vβ gene segment. As a result, there is a complete Vβ-Dβ-Jβ rearrangement.
Although there are also some other types of rearrangements such as Dβ-Dβ and Vβ-Dβ, every rearrangement linkage has its unique structure. Consequently, there is a detectability of more than one rearrangement in each allele.
What does molecular analysis reveal?
The major molecular analysis exhibits the rearrangements including the rearrangements of TCRB. This is especially helpful for the diagnostic clonality in suspected T-cell proliferation.
The detection of arrangements revealed by TCRB is of major interest for a number of minimal residual disease (MRD). Such diseases are majorly found in lymphoproliferative disorders. That is because there is an extensive combinatorial repertoire and not to mention the much diverse junctional regions. These entire TCRB rearrangements are not just detectable in major malignancies related to T-cells, but they also have been found in about 35% of precursor B-ALL.
When can the TCR gene analysis be performed?
The analysis related to TCR gene rearrangements can quite easily be performed either by Southern blot (SB) analysis. For a very long time, this analysis has been considered as the yardstick by PCR for clonality assessment.
Since SB is a very time-consuming and labour-intensive method that requires a high molecular weight DNA and the rapid, it is being considered as a sensitive PCR technique that is applied to clonality assessment.
However, there are certain complications posed by recombinatorial repertoire, which then hampers the TCRB PCR methods necessary for degenerated consensus. These act as primers that actively limit the number of detectable rearrangements.
The whole approach of TCRB PCR is curated as a multiplex PCR technique, that helps for the identification of incomplete Dβ-Jβ rearrangements and complete Vβ-Jβ bondage.
There are 23 family-specific Vβ primers, these primers designed to primarily recognize the functional Vβ gene segments. The 13 specific Jβ primers and the two major Dβ primers are considered to be the most complete Vβ-Jβ in theory. Consequently, this rearrangement bondage can be detected by three multiplex tubes of BIOMED-2.
How did the standardization of BIOMED-2 come into being?
Within the last two decades, the extensive experience went into the PCR analysis of TCRD and TCRG rearrangements. This consequently is considered a huge help in terms of not only the standardization but also the design of BIOMED-2.
Since there was no reliable method for PCR before the invention of TCRB genes. The results of PCR are obtained with a very futuristic developed method. This then needs to be compared to the conventional or classical analysis of SB.
As a result of all of this scientists developed a very comprehensive validation study of the TCRB multiplex PCR. This is done by directly comparing the frequency of PCR detection and the incomplete TCRB rearrangements.
The bone marrow or peripheral blood samples are firstly selected from a total of 66 patients. It was made sure that every patient T-ALL (31 CD3 negative, 20 TCRαβ+, 15 TCRγδ+). Moreover, it was also established that there would be a need for 36 mature TCRαβ+ malignancies. The malignancies in question included around 20 T-cell and large granular lymphocyte leukaemia. Every sample was analyzed by previous SB analysis. As previously described, the DNA for the analysis done by PCR was extracted several times and stored at around 80 degrees celsius.
Langerak, D. J., & Groenen P. (2004, July 29). Validation of BIOMED-2 multiplex PCR tubes for detection of TCRB gene rearrangements in T-cell malignancies. Leukemia, 18,