Huang Hongdong, Sun Weiming, Liang Yumei, Long Xi-Dai, Peng Youming, Liu Zhihua, Wen Xiaojun, Jia Meng
Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University , P.R. China .
Ren Fail. 2014 Sep;36(8):1263-7. doi: 10.3109/0886022X.2014.934649. Epub 2014 Jul 3.
CD(+)(4)CD(+)(25) Treg cells are of critical importance for maintenance of tolerance. The purpose of the this study was to observe the number of CD(+)(4)CD(+)(25) Treg cells in the patients with thrombotic thrombocytopenic purpura (TTP) associated with systemic lupus erythematosus (SLE), and to study pathogenesis of TTP with SLE.
Seven patients with TTP associated with SLE and seven healthy volunteers were studied. The CD(+)(4)CD(+)(25) Treg cells were examined by flow cytometry. Clinical and laboratory data, such as urinary protein, serum creatinine, endothelial markers and immunologic serologics, were obtained from each patient and healthy volunteer. Glomerular injury was assessed by histopathology. Serum IL-2, IL-4, IL-6 and anti-endothelial cell antibody were analyzed by ELISA and anti-ADAMTS13 antibody were detected by Western blotting.
CD(+)(4)CD(+)(25) Treg cells significantly decreased in TTP with SLE patients compared with controls (p < 0.05). CD(+)(4)CD(+)(25) Treg cells are negatively correlated with blood urea nitrogen, serum uric acid, supernatant IL-4, and proteinuria, and positively with estimated glomerular filtration rate (eGFR) in TTP with SLE patients. [Formula: see text] Treg cells gradually decreased as the severity of renal histology increased. Serum IL-2, IL-6, supernatant IL-4, anti-endothelial cell antibody, and anti-ADAMTS13 antibody significantly increased in TTP with SLE patients compared to those of the control groups (all p < 0.05). In contrast, serum levels of C3 were significantly decreased in TTP with SLE patients compared to those of the control groups (p < 0.05).
CD(+)(4)CD(+)(25) Treg cells are not only lower in TTP with SLE patients, but also are correlated with disease severity in TTP with SLE patients.CD(+)(4)CD(+)(25)Treg cells may play an important role in the pathogenesis of TTP with SLE.
CD(+)4CD(+)25调节性T细胞对于维持免疫耐受至关重要。本研究旨在观察系统性红斑狼疮（SLE）相关血栓性血小板减少性紫癜（TTP）患者体内CD(+)4CD(+)25调节性T细胞的数量，并探讨SLE合并TTP的发病机制。
研究7例SLE相关TTP患者及7名健康志愿者。采用流式细胞术检测CD(+)4CD(+)25调节性T细胞。收集每位患者及健康志愿者的临床和实验室数据，如尿蛋白、血清肌酐、内皮标志物及免疫血清学指标。通过组织病理学评估肾小球损伤情况。采用酶联免疫吸附测定（ELISA）分析血清白细胞介素-2（IL-2）、IL-4、IL-6及抗内皮细胞抗体水平，采用蛋白质印迹法检测抗ADAMTS13抗体。
与对照组相比，SLE合并TTP患者的CD(+)4CD(+)25调节性T细胞显著减少（p < 0.05）。在SLE合并TTP患者中，CD(+)4CD(+)25调节性T细胞与血尿素氮、血清尿酸、上清液IL-4及蛋白尿呈负相关，与估计肾小球滤过率（eGFR）呈正相关。[公式：见原文]随着肾脏组织学严重程度增加，调节性T细胞逐渐减少。与对照组相比，SLE合并TTP患者的血清IL-2、IL-6、上清液IL-4、抗内皮细胞抗体及抗ADAMTS13抗体显著升高（均p < 0.05）。相反，与对照组相比，SLE合并TTP患者的血清C3水平显著降低（p < 0.05）。
SLE合并TTP患者不仅CD(+)4CD(+)25调节性T细胞数量减少，且与SLE合并TTP患者的疾病严重程度相关。CD(+)4CD(+)25调节性T细胞可能在SLE合并TTP的发病机制中起重要作用。
