Expression And Significance Of T Helper Cells In Patients With Systemic Lupus Erythematosus

Objective To investigate the expression and significance of Thl, Th2, Th17, Treg cells and Thl/Th2, Th17/Treg in the peripheral blood of patients with systemic lupus erythematosus(SLE) and lupus nephritis(LN).Methods The percentage of Thl, Th2, Thl7 and Treg cells in the peripheral blood of 103 patients with SLE (including 40 SLE patients with lupus nephritis)and 23 healthy volunteers were detected by flow cytometry. The disease activity of SLE was measured by SLEDAI. SLE patients were divided into four groups:inactive SLE (SLEDAI0-4, n=16), light SLE (SLEDAI 5-9, n=29), medium SLE (SLEDAI 10-14, n=26) and serious SLE (SLEDAI≥15, n=32). The correlations between the expression of Thl, Th2, Th17, Treg cells and SLEDAI, LN in SLE patients and healthy controls were analyzed respectively.Results (1)The percentages of Th17 in the peripheral blood in patients with light、 medium and serious SLE were higher than that in normal controls(P=0.0000,0.0000, 0.0000)and inactive SLE(P=0.0001,0.0000,0.0000); The percentages of Th17 in patients with medium and serious SLE were higher than that in inactive SLE(P=0.0173, 0.0009); The percentage of Th17 in patients with LN was higher than that in non-LN(P =0.0008); The percentages of Th17 in patients with active new-onset SLE was higher than that in normal controls and inactive SLE(P=0.0000,0.0004); The percentage of Th17 in patients with recurrent SLE was higher than that in inactive SLE(P=0.0002); The percentage of Th17 in patients with new-onset SLE had no obvious difference to recurrent SLE(P=0.2419); The percentage of Th17 in patients with reduced level of complements SLE was higher than that in normal levels of complements SLE and controls(P=0.0000,0.0000); The percentage of Th17 was positively correlated to disease activity. (2)The percentage of Treg in the peripheral blood in patients with serious SLE was lower than that in normal controls, inactive and light SLE(P= 0.0027, 0.0103,0.0446); The percentage of Treg in patients with LN SLE had no obvious difference to non-LN SLE(P=0.2568); The percentage of Treg in patients with active new-onset SLE was lower than that in normal controls and inactive SLE(P=0.0076, 0.0019); The percentage of Th17 in patients with active recurrent SLE was lower than that in controls((P=0.0261)); The percentage of Th17 in patients with new-onset SLE had no obvious difference to recurrent SLE(P=0.8351); The percentage of Treg in patients with reduced levels of complements SLE was lower than that in controls(P=0.0415).(3)The ratios of Thl7/Treg in patients with light, medium and serious SLE were higher than that in normal controls(P=0.0044,0.0006,0.0000); The ratios of Thl7/Treg in patients with medium and serious SLE were higher than that in inactive(P=0.0075,0.0002)and light SLE(P=0.0417,0.0044); The ratio of Thl7/Treg in patients with LN was higher than that in non-LN(P=0.0429); The ratios of Th17/Treg in patients with active new-onset SLE was higher than that in controls and inactive SLE(P =0.0000,0.0000); The ratio of Thl7/Treg in patients with recurrent SLE was higher than that in inactive SLE(P=0.0150); The ratio of Thl7/Treg in patients with new-onset SLE had no obvious difference to recurrent SLE(P=0.9397);The ratio of Th17/Treg in patients with reduced levels of complements was higher than that in normal levels of complements and controls(P=0.0020,0.0000); The ratio of Th17/Treg was positively correlated to disease activity. (4)The percentages of Thl in the peripheral blood of patients with light, medium and serious SLE were higher than that in normal controls(P=0.0008,0.0004,0.0000); The percentages of Thl in patients with LN and non-LN were higher than that in normal controls(P=0.0000,0.0000); The percentage of Thl in patients with reduced level of complements was higher than that in controls(P=0.0000); The percentage of Thl was not correlated to disease activity. (5)The percentages of Th2 in the peripheral blood in patients with inactive, light, medium and serious SLE were higher than that in normal controls(P=0.0212, 0.0205,0.0339,0.0247); The percentages of Th2 in patients with LN and non-LN were higher than that in controls(P=0.0016,0.0202); The percentage of Th2 was not correlated to disease activity. (6)The ratios of Thl/Th2 in patients with inactive, medium and serious SLE were higher than that in controls(P=0.0002,0.0012,0.0019); The ratios of Thl/Th2 in patients with LN and non-LN were higher than that in controls(P=0.0023,0.0004); The ratio of Thl/Th2 was not correlated to disease activity.Conclusion There is an abnormal elevation of Th17 cells and decrease of Treg cells in PBMC of SLE patients. The ratio of Thl7/Treg was positively correlated to disease activity. The imbalance between Thl/Th2 and Thl7/Treg cells may play a critical role in the pathogenesis of SLE.