Expression Of CD3~-CD16~+CD56~+NK Cells In Peripheral Blood Of Patients With Systemic Lupus Erythematosus And Its Correlation With Disease Activity

BackgroundSystemic lupus erythematosus(SLE)is an autoimmune disease caused by multiple organ damage due to the formation and deposition of a large number of immune complexes.Lupus nephritis(LN)is a clinical manifestation of SLE combined with different renal pathological types and immune damage.In recent years,more and more studies have found that immunological mechanisms are of great significance in the pathogenesis and progress of SLE and LN.The mechanisms of natural killer cells(NK)in the pathogenesis of SLE and LN are not fully understood.The aim of this study was to investigate the immune function of NK cells in the pathogenesis of SLE and LN.ObjectiveIn this study,the lymphocyte subsets in peripheral blood of SLE patients were detected by collecting and detecting various clinical indexes,and the changes of lymphocyte subsets in SLE patients were investigated.The correlation between the changes of NK cell subsets and the development of SLE and LN was analyzed,thus the role of NK cells in the pathogenesis of SLE and LN was studied.MethodsA total of 168 subjects,134 SLE patients and 34 health examiners were collected in this study,all from the patients in the nephrotic Immunology Department of Henan Province People's Hospital and the patients in the hospital and physical examination center.134 cases of SLE patients were all in accordance with the revised classification standards of ACR in 1997,and were scored according to the SLE activity index(SLEDAI)2000 scale.There were 54 patients with active SLE,including 40 cases of primary active SLE,14 cases of SLE in recurrent active phase and 80 cases of non active SLE patients.There were 51 cases in group LN and 83 cases in non LN group based on renal involvement,and 34 normal controls were matched with group SLE in sex and age.Serum samples,general information and clinical indicators of all subjects were collected.The NK cell subsets were detected by flow cytometry.The antinuclear antibodies,anti dsDNA antibodies and anti C1q antibodies were detected by enzyme-linked immunosorbent assay(ELISA).The data were statistically analyzed with SPSS 24.0 software.Independent sample T test and rank sum test were used for the difference between groups.The correlation analysis was tested by Pearson test and Spearman rank correlation test.Results1.There was no significant difference in age and sex constituent ratio among all groups(P>0.05).In group SLE,the levels of platelet,hemoglobin,IgM,C3 and C4were lower than those in the normal group(P<0.01).The levels of IgA,IgG,ESR,CRP,urinary protein,anti ds-DNA antibody and anti C1q antibody were higher than those in the normal group(P<0.05).The difference was statistically significant.The levels of C3 and C4 in the active group were lower than those in the non active group(P<0.01).The SLEDAI score,ESR,CRP,urine protein quantitative,anti dsDNA antibody and anti C1q antibody were higher than those in the non active group(P<0.05).The positive rate of anti nuclear antibody in the active group was higher than that in the non active group(P<0.001).The levels of CRP,urinary protein and anti C1q antibody were higher than those in non LN group(P<0.05).There was no significant difference in the positive rate of antinuclear antibody between the two groups.2.The lymphocyte,CD3~+T cells,CD3~+CD4~+T cells and CD4~+/CD8~+ratio in the group SLE were lower than the normal group(P<0.05),and the CD19~+B cells in SLE group were higher than that of the normal control group(P<0.01).Lymphocytes in the activity group were lower than those in the inactive group(P<0.001),and lymphocytes in group LN were lower than those in non LN group(P<0.05).Lymphocytes,CD3~+T cells and CD3~+CD4~+T cells in the active group were lower than those in the non active group(P<0.05),and the lymphocyte,CD3~+T and CD3~+CD4~+T cells in the group LN were lower than the non LN group(P<0.05),and the CD3~+T cells were negatively correlated with the SLEDAI score,the urine protein quantitative,ESR and the anti C1q antibody.CD3~+CD4~+T cells were negatively correlated with SLEDAI score and anti C1q antibody(P<0.05),and positively correlated with hemoglobin and platelets(P<0.001).3.The percentage and count of SLE group CD3~-CD16~+CD56~+NK cells were lower than normal group(P<0.001).The percentage of CD3~-CD16~+CD56~+NK cells in the activity group was lower than that in the inactive group(P<0.05),and the CD3CD16~+CD56~+NK cell count was lower than that in the inactive group(P<0.001).The number of CD3~-CD16~+CD56~+NK cells in group LN was lower than that in non LN group(P<0.001);CD3~-CD16~+CD56~+NK cell(/uL)was negatively correlated with SLEDAI score,urine protein quantitative and anti dsDNA antibody(P<0.001),and was positively related to C3 and platelets(P<0.05).Conclusions1.In patients with SLE,CD3~+T cells,CD3~+CD4~+T cells,CD19~+B cells and CD3~-CD16~+CD56~+NK cells were involved in the occurrence and development of SLE.2.CD3~+T cells,CD3~+CD4~+T cells and CD3~-CD16~+CD56~+NK cells in SLE patients were correlated with the severity of the disease.3.The change of CD3~-CD16~+CD56~+NK cells is closely related to renal injury in LN patients.