Li Z G, Mu R, Dai Z P, Gao X M
Department of Rheumatology and Immunology, People's Hospital, Beijing, China.
Lupus. 2005;14(11):884-9. doi: 10.1191/0961203305lu2239oa.
Systemic lupus erythematosus (SLE) is an autoreactive T cell mediated autoimmune disease. Immunization with inactivated autoreactive T cells may induce idiotype anti-idiotypic reaction to deplete specific subsets of autoreactive T cells involved in SLE. Six SLE patients unsuitable or refused to use immunosuppressants were treated with T cell vaccination. Their clinical manifestations and laboratory parameters including mixed lymphocyte reactions were evaluated. Autoreactive T cell clones were derived from peripheral blood mononuclear cells of the patients and 1 X 10(7) irradiated T cells were inoculated subcutaneously at 0, two, six and eight weeks, respectively. The enrolled patients were followed up for 32-40 months at an interval of three to six months. The clinical characteristics and laboratory abnormalities improved after inoculation without increasing the dose of corticosteroids and immunosuppressants in most patients. SLE disease activity index (SLEDAI) scores decreased. Proliferative responses against the T cell vaccine were observed in four of six patients. At the time of this report, the six patients remain in clinical remission. No significant side effect from the vaccination was noticed during the follow-up period. The results of this pilot study indicate that T cell vaccination is a safe and effective treatment in SLE.
系统性红斑狼疮（SLE）是一种自身反应性T细胞介导的自身免疫性疾病。用灭活的自身反应性T细胞进行免疫接种可能会诱导独特型抗独特型反应，以耗尽参与SLE的自身反应性T细胞的特定亚群。对6例不适合或拒绝使用免疫抑制剂的SLE患者进行了T细胞疫苗接种治疗。评估了他们的临床表现和实验室参数，包括混合淋巴细胞反应。从患者外周血单个核细胞中获得自身反应性T细胞克隆，并分别在第0、2、6和8周皮下接种1×10⁷经照射的T细胞。对纳入的患者进行了32至40个月的随访，随访间隔为3至6个月。在大多数患者中，接种后临床特征和实验室异常情况有所改善，且未增加皮质类固醇和免疫抑制剂的剂量。SLE疾病活动指数（SLEDAI）评分降低。6例患者中有4例观察到针对T细胞疫苗的增殖反应。在本报告发布时，这6例患者仍处于临床缓解期。随访期间未发现疫苗接种有明显副作用。这项初步研究的结果表明，T细胞疫苗接种是SLE的一种安全有效的治疗方法。
