| Objective1.To compare the changes of CD4+CD25+Foxp3+Treg and other T subsets[total T,CD4+T,CD8+T,T helper 1(Th1),T helper 2(Th2),and T helper 17(Th17)cells]levels in peripheral blood(PB)of patients with autoimmune diseases(AID)[include rheumatoid arthritis(RA),Sjogren's syndrome(SS),systemic lupus erythematosus(SLE),ankylosing spondylitis(AS),systemic vasculitis(SV),and idiopathic inflammatory myopathy(IIM)]and healthy controls.2.To analyze the correlation between the levels of peripheral T lymphocyte subsets and clinical parameters in AID.3.To analyze the relationship between PB T lymphocyte subsets and the treated with hormones and/or biological or non-biological disease-modifying anti-rheumatic drugs(DMARDs)in patients with AID.4.To analyze the relationship between peripheral blood T lymphocyte subsets and the involvement of important organs in patients with AID.MethodsA total of 1561 AID(495 males and 1066 females,aged 50.69±14.59 years)from the rheumatology department of the Second Hospital of Shanxi Medical University were enrolled from December 2016 to December 2017,including 888 cases of RA,212 SS,160 SLE,131 AS,100 SV and 70 IIM.The disease duration was 7.17±8.30 years.The clinical and laboratory data were complete.The 196 age-and sex-matched healthy adults were recruited from our hospital's physical examination center in the same period as the healthy controls,including 56 males and 140 females,aged 49.22±13.46 years,with no history of rheumatism and family history.The demographic data of each group matched those of the healthy controls.The absolute numbers of CD4~+CD25~+Foxp3~+Treg and other T subsets[total T,CD4+T,CD8+T,Th1,Th2,and Th17 cells]in PB were measured by Flow Cytometer(FCM).Compare the changes of CD4+CD25+Foxp3+Treg and other T subsets[total T,CD4+T,CD8+T,T helper 1(Th1),T helper 2(Th2),and T helper 17(Th17)cells]levels in PB of patients with AID(include RA,SS,SLE,AS,SV,and IIM)and healthy controls.Analyzed the relationship between PB T lymphocyte subsets and the treated with hormones and/or biological or non-biological disease-modifying anti-rheumatic drugs(DMARDs)and the involvement of important organs in patients with AID.Data were analyzed by t test,Mann-Whitney U test,?~2 test and Spearman correlation analysis.Results1.The absolute numbers of PB Treg cells[22.90(18.31,36.47)vs 30.24(21.85,41.34)],total T,CD8~+T and Th17 cells in AID patients were significantly lower than those in healthy controls(P<0.05).While the levels of CD4~+T/Treg,Th1/Treg and Th2/Treg in PB of the AID patients were significantly higher than those of healthy controls(P<0.05).There was no significant difference in the levels of CD4~+T,Th1,Th2 cells,total T/Treg,CD8~+T/Treg and Th17/Treg between the AID patients and the healthy controls(P>0.05).2.The levels of inflammatory indicators(ESR,CRP)were inversely associated with the counts of Treg,total T,CD4~+T,CD8~+T,Th1 cells and the ratio of Th1/Treg.The levels of complement C3 and C4 were positively correlated with the counts of Treg,total T,Th2cells,while the level of Th17/Treg was negatively correlated with complement C3 and C4.The levels of Treg,total T,CD4~+T,CD8~+T,Th1,Th2,Th17 cells,and Th1/Treg were positively correlated with the course of disease(P<0.05).3.The levels of Treg,total T,CD8~+T,Th1 and Th17 cells in PB of the RA patients were significantly lower than those of healthy controls.While the levels of CD4~+T/Treg and Th2/Treg in PB of the RA patients were significantly higher than those of healthy controls(P<0.05).There was no significant difference in the levels of CD4~+T cell,Th2 cell,total T/Treg,CD8~+T/Treg,Th1/Treg and Th17/Treg between the RA patients and healthy controls(P>0.05).4.The absolute levels of PB Treg,total T,CD4~+T,CD8~+T,Th2 and Th17 cells in SS patients were significantly lower while the levels of CD4~+T/Treg and Th1/Treg in PB of the SS patients were significantly higher than those of healthy controls(P<0.05).There was no significant difference in the levels of Th1,total T/Treg,CD8~+T/Treg,Th2/Treg and Th17/Treg between the SS patients and healthy controls(P>0.05).5.The absolute levels of PB Treg,total T,CD4~+T,CD8~+T,Th1,Th2 and Th17 cells in SLE patients were significantly lower while the ratios of total T/Treg,CD4~+T/Treg,CD8~+T/Treg,Th1/Treg,Th2/Treg and Th17/Treg in PB of SLE patients were significantly higher than those of healthy controls(P<0.05).6.The levels of total T,CD4~+T,CD8~+T,Th1,Th17,CD4~+T/Treg,Th1/Treg,Th2/Treg,and Th17/Treg in PB of AS patients were significantly higher than those of healthy controls(P<0.05).There was no significant difference in the levels of Treg,Th2,total T/Treg and CD8~+T/Treg between the AS patients and healthy controls(P>0.05).7.The absolute numbers of PB Treg cells in SV patients were significantly lower while the levels of Th1 cell,total T/Treg,CD4~+T/Treg,CD8~+T/Treg,Th1/Treg,Th2/Treg and Th17/Treg in PB of SV patients were significantly higher than those of healthy controls(P<0.05).There was no significant difference in the levels of totalT,CD4~+T,CD8~+T,Th2,and Th17 cells between the SV patients and healthy controls(P>0.05).8.The absolute numbers of PB Treg,total T,CD4~+T,CD8~+T,Th1,Th2,and Th17 cells and ratio of Th1/Treg in IIM patients were significantly lower than those of healthy controls(P<0.05).There was no significant difference in the levels of total T/Treg,CD4~+T/Treg,CD8~+T/Treg,Th2/Treg,Th17/Treg between the IIM patients and healthy controls(P>0.05).9.The patients were divided into the primary treatment group and retreated group according to whether they had been treated with hormones and/or biological or non-biological disease-modifying anti-rheumatic drugs(DMARDs).The levels of Treg,total T,CD4~+T,Th2 cells in PB of the retreated group were significantly lower than those of the primary treatment group.The levels of total T/Treg,CD8~+T/Treg in PB of the retreated group were significantly higher than those of the primary treatment group(P<0.05).10.According to the involvement of important organs,the patients were classified into two groups:organ group and non-organ group.The levels of Treg,total T,CD4~+T,Th1,Th2,Th17 cells in organ group were lower than those in non-organ group,while the ratio of total T/Treg,CD8~+T/Treg in organ group were significantly higher than those in non-organ group(P<0.05).ConclusionIn AID,the absolute numbers or function of CD4~+CD25~+Foxp3~+Treg cells were decreased,so it cannot effectively maintain immune tolerance or inhibit inflammatory response,which may be one of the important mechanisms of disease.Treatment promoting the function of CD4~+CD25~+Foxp3~+Treg cells may become a new strategy for AID therapy. |
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