Change Of CD4~+CD25~+T Cells In Peripheral Blood Of Patients With Early New-onset Systemic Lupus Erythematosus

Objective: Systemic lupus eythematosus is a kind of autoimmune diseasewith multi systemic and multi-organ impairments. Etiology and pathogenesisis still not clear at present. Most of the studies think that its reason is the lossof immune tolerance to self antigens and autoreactive immune cells inducedby losing control. Regulatory T cells (Treg) is a group of cell populations thatmaintaining the immune tolerance and immune homeostasis, regulatory Tcells play an important role in the development of autoimmune diseases. TheCD4~+CD25~+T cells are the most widely studied, the exact function ofregulatory T cells at present.Studies have found that CD4~+CD25~+T cells canplay immunosuppressive effect on a variety of immune cells, and that haveimmunomodulatory effects on the body’s innate immunity and acquiredimmunity, CD4~+CD25~+T cells can also control the immune response afer thebody be damaged, and reduce the body’s inflammatory response and tissuedamage by cytokines that the inhibition of monocyte and macrophage product.Studies found that the number of peripheral blood CD4~+CD25~+Tcells withactive patients in systemic lupus erythematosus were decreased significantlythan non-active patients, the expression level of CD4~+CD25~+T cell andSLEDAI score was negatively correlated, and the expression levels ofCD4~+CD25~+T cell have closely related to kidney damage, there is speculationthat the changes of CD4~+CD25~+T cells may be a cause of occurrence,development and organ injury with systemic lupus erythematosus. Thepurpose of this study is to observe the positive rate of CD4~+CD25~+T cells inperipheral blood of patients with early new-onset systemic lupuserythematosus, the relationship between the expression levels of CD4~+CD25~+Tcell and disease activity, organ damage, and study what the role CD4~+CD25~+Tcells play in occurrence, development and organ injury of systemic lupus erythematosus.Methods:140peripheral blood samples were chosen and they were divided into groups:(1)systemic lupus erythematosus group (Group A), i.e.22cases of SLE patients;the patients consistent with the1997American Rheumatism Associationdiagnostic criteria of systemic lupus erythematosus, and were initiallydiagnosed without the use of hormones and immunosuppressive agents, andnot combined with other connective tissue diseases; According to the SLEDAIscore in22patients were divided into SLE moderate and severe active group(A1group)(SLEDAI score≥10) and SLE low-active group (A2group)(SLEDAI score≤9points) for understanding correlation between diseaseactivity and CD4~+CD25~+T cell; According to the anti ds-DNA positive or not,divided into group C1(anti ds-DNA positive group) and C2(anti ds-DNAnegative group); For understanding CD4~+CD25~+T cell and organ damagerelations, according to the presence or absence of the kidney and the damageof blood system divided into group D1(SLE combined kidney and bloodsystem damage group) and group D2(SLE without kidney and blood systemdamage group);(2) Normal control group (Group B),18cases of sex and agematched healthy volunteers.2Flow cytometric analysis was employed for the expression level of CD4~+CD25~+T cells in the peripheral blood of systemic lupus erythematosus andhealthy volunteers.During this period, the clinical manifestations (includingfever, emerging rash,arthritis, hair loss, raynaud’s phenomenon, centralnervous system damage) were recorded, also, the laboratory exminationresults (including blood examination、urine examination、stool examination、urinary sediment、quantitate of24hour urine protein、liver function、renalfunction、 immunoglobulin、 alexine、 antinuclear antibody、 antibodyanti-dsDNA antibody、echocardiography、abdominal ultrasonography、electro-cardiogram、lung CT) and the disease activity scores were included, and soon. 3Statistical analysis of data:Using the statistical software of SPSS13treatment data the data presented as x±S. The measurement data wereanalyzed with two independent samples t test if Two samples were normaldistribution and variance, if not, using rank-sum test. P<0.05for the differencewas statistically significant. correlation between the two variables wasanalyzed using Pearson correlation analysis method.Results:1The positive rate of CD4~+CD25~+T cell(3.408±2.133％)in peripheral bloodof patients with systemic lupus erythematosus were higher than normalcontrol(2.856±1.424％), the differences were not statistically significance.2the systemic lupus erythematosus patients according to SLEDAI score weredivided into active patients group and the low active patients group, comparedwith normal control group:the positive rate of CD4~+CD25~+T cell(2.964±1.649％)in systemic lupus erythematosus activie group and low activegroup(3.940±2.591％)were higher than in the normal control group, but thethree groups had no significant differences between each other.3The positive rate of CD4~+CD25~+T cells in peripheral blood of patients wasno difference between the anti ds-DNA positive and anti ds-DNA negativewith systemic lupus erythematosus.4The positivhe rate of CD4~+CD25~+T cells in peripheral blood of patients withkidney and blood system damaged were decreased than without kidney andblood system damaged, he difference was not statistically significance.5The expression level of CD4~+T cells (25.649±8.946%) in peripheral bloodof patients with systemic lupus erythematosus were decreased than normalcontrol(33.684±12.601%), the differences were statistically significance.6The expression level of CD4~+T cells in systemic lupus erythematosusmoderate and severe active group were decreased than in the normal controlgroup, the differences were statistically significance.7The expression level of CD4~+CD25~+T cells and SLEDAI score were notcorrelated. 8The expression level of CD4~+CD25~+T cells didn’thave obvious relationshipswith protein in the urine, fever, rash, the white blood cells, alexine, alopecia,raynaud phenomenon.Conclusions:1The positive rate of CD4~+CD25~+T cells in peripheral blood was nodifference between patients with the systemic lupus erythematosus and normalcontrol, so that no association between the expression level of CD4~+CD25~+Tcell in the peripheral blood and systemic lupus erythematosus disease occurs.2Detection of the change of CD4~+CD25~+T cells in peripheral blood ofpatients with systemic lupus erythematosus is no reference value to understandsystemic lupus erythematosus disease activity.3There are no association between the expression level of CD4~+CD25~+T cellin the peripheral blood and kidney and blood system damage of systemiclupus erythematosus patients.4CD4~+T cells decreased at patients with systemic lupus erythematosus inperipheral blood may be associated with increased of the presence of CD4+Twith systemic lupus erythematosus patients in vivo.