Effects Of Glucocorticoids On The Expression Of Glucocorticoid-induced Tumor Necrosis Factor Receptor And Apoptosis Of The Regulatory T Cells In Patients With Systemiclupus Erythematosus

Obstract To investigate the expression of glucocorticoid-induced tumor necrosisfactor receptor (GITR) and apoptosis in CD4+CD25+CD127dim/-T cells of the patientswith systemic lupus erythematosus (SLE),analysis of its clinical value.Methods28patients (28female,mean age25.24±5.86years, range from18to42years) with a diagnosis of SLE according to the American College ofRheumatology(ACR)1997criteria were included in the study. All SLE patients werereferred to the Department of Rheumatology and Immunology, Anhui ProvincialHospital.12normal volunteer (10women and2men, mean age25.13±1.28years,range26to36years) without history of autoimmune diseases were also included inthis study. All subjects received informed consent in this study. The SLE patientswere divided into active group (SLEDAI≥10) and inactive group (SLEDAI<10)according to the SLE disease activity index (SLEDAI). Active group included15patients, inactive group included13patients. Peripheral bloodCD4+CD25+CD127dim/-T cells were isolated by magnetic beads sorting.We classifiedthem into two subgroups: the blank group and therapeutic dose group(Dexamethasone dose5×10-2ug/ml and cultured for48hours). The T cells were collected, andaveragely divided into5tubes. the first one was set as blank,the others wereanti-GITR-APC(2μL)、 AnnexinV-FITC(2μl)、 AnnexinV-FITC(2μL) and anti-GITR-APC(2μL).After incubatting the samples for30min at4°C with avoidance oflight. The cells were eluted with PBS solution (2mL) twice. and were ready to beanalyzed by flow cytometry. All the data were collected by FACSCalibur flowcytometer (FACSealibur system,BD). The expression of GITR and AnnexinV wereanalyzed by flow cytometry before and after cultured. The correlations between GITRlevels,apoptosis rates of these subsets and the clinic,laboratory parameters of SLEwere analyzed.Results GITR levels and apoptosis rates in patients with SLE were significantlyhigher than that in normal control group (P=0.016；P=0.049).The expression levelsof GITR on Treg cells between blank groups and therapeutic dose groups were foundno significant difference in patients with SLE (P>0.05),but in normal group theexpression levels of GITR in therapeutic dose group were higher than that in blankgroup(P=0.034). After adding dexamethasone, The apoptosis rates of Treg cells weredecreased in patients with SLE, the difference was statistically significant (P=0.033);But in normal control group,that was higher in therapeutic dose group than that inblank group (P=0.012). The expression levels of GITR on Treg cells weresignificantly positively correlated with the disease active index in SLE (SLEDAI),Butwere correlated negatively with the C3.Conclusion The GITR pathological expressed on Treg cells in SLE, it may be used as an immunological index of SLE disease activity; glucocorticoids may regulateimmune abnormalities in patients with SLE by inhibiting Treg cells apoptosis.