Szmyrka-Kaczmarek Magdalena, Kosmaczewska Agata, Ciszak Lidia, Szteblich Aleksandra, Wiland Piotr
Postepy Hig Med Dosw (Online). 2014;68:893-8. doi: 10.5604/17322693.1111127.
The balance between proinflammatory Th17 cells and regulatory T cells plays an important role in the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE). In particular, an increased ratio of Th17/Treg cells has been shown to correlate with active SLE and specific organ involvement. The aim of our study was to assess Th17 and Treg cell populations in peripheral blood (PB) of patients with clinically quiescent SLE, and to evaluate their correlation with organ involvement.
MATERIAL/METHODS: We performed flow cytometric analysis of studied T CD4+ cell subpopulations in PB from 21 patients with SLE and 13 healthy controls. Disease activity was measured with the SELENA-SLEDAI index; organ involvement was divided into renal, neurological and hematological.
A statistically significant difference (p<0.01) between the mean percentages of CD4+CD25highFoxP3+ Treg cells in SLE patients (18.57%) and healthy controls (32.08%) was observed. Similarly, proportions of functional CTLA-4+ Treg cells were markedly lower in SLE patients than in healthy controls--19.3% vs. 23.82% (p=0.03). In contrast, SLE patients exhibited a significantly increased frequency of circulating Th17 cells with the phenotype CD4+IL-17+ compared to controls--1.36 % vs 0.19% (p<0.01). Also the ratio of Th17 cells to Th1 cells was markedly higher in SLE patients than in the control group (p<0.01). We did not find any correlation of PB Th cell distribution with organ involvement in SLE patients examined.
Our report showed for the first time that systemic Th17/Treg imbalance occurred also in patients with low disease activity and in remission. We suggest that immunological alterations may precede clinical and laboratory symptoms of the disease activity.
促炎性Th17细胞与调节性T细胞之间的平衡在自身免疫性疾病（包括系统性红斑狼疮，SLE）的发病机制中起着重要作用。特别是，Th17/Treg细胞比例增加已被证明与活动性SLE及特定器官受累相关。我们研究的目的是评估临床静止期SLE患者外周血（PB）中的Th17和Treg细胞群体，并评估它们与器官受累的相关性。
材料/方法：我们对21例SLE患者和13名健康对照者的PB中研究的T CD4 +细胞亚群进行了流式细胞术分析。用SELENA-SLEDAI指数测量疾病活动度；器官受累分为肾脏、神经和血液学方面。
观察到SLE患者（18.57%）和健康对照者（32.08%）中CD4 + CD25highFoxP3 + Treg细胞的平均百分比之间存在统计学显著差异（p < 0.01）。同样，SLE患者中功能性CTLA-4 + Treg细胞的比例明显低于健康对照者，分别为19.3%和23.82%（p = 0.03）。相比之下，与对照组相比，SLE患者中具有CD4 + IL-17 +表型的循环Th17细胞频率显著增加，分别为1.36%和0.19%（p < 0.01）。SLE患者中Th17细胞与Th1细胞的比例也明显高于对照组（p < 0.01）。我们未发现所检查的SLE患者PB中Th细胞分布与器官受累之间存在任何相关性。
我们的报告首次表明，疾病活动度低且处于缓解期的患者也会出现全身性Th17/Treg失衡。我们认为免疫改变可能先于疾病活动的临床和实验室症状出现。
