| Objective1.To compare the general condition and the difference of peripheral blood lymphocytes between systemic lupus erythematosus(SLE)and healthy people.2.To determine the effect of immunologic purging on peripheral blood lymphocytes,cytokines,erythrocyte sedimentation rate,complement,anti-ds-DNA antibody,blood routine,24-hour urinary protein and SLEDAI score in SLE patients and evaluate its safety.Methods1.A total of 197 subjects were included in this study,including 104 SLE patients hospitalized in our hospital from January 2018 to June 2019,and 93 healthy persons matched with the age and sex of SLE patients in the same period.The SLEDAI scores of104 SLE patients were all more than 9.2.A total of 104 SLE patients were randomly divided into immunologic purging group(n=52)and non-purging group(n=52).The patients in the non-purging group were given oral prednisone acetate(50-60mg/day)and palliative drugs(hydroxychloroquine,mycophenolate mofetil,leflunomide,etc.).In the immunologic purging group,except for the treatment of non-purging group,immunologic purging therapy was added:DFPPEC-30W+DFPPEC-20W+DFPPEC-30W or DFPPEC-30W+DFPPEC-20W+IA PH-350,once every other day,three times per person;3.Flow cytometry was used to detect the number of peripheral blood lymphocytes in 93healthy people and 104 SLE patients at 0,1,12,24,36 weeks,and CBA was used to detect the expression of related cytokines IL-2,IL-4,IL-6,IL-10,IL-17,TNF-?and IFN-?in serum of 104 SLE patients at 0,1,12,24 and 36 weeks.At the same time,the clinical data of ESR,complement,anti-ds-DNA antibody,blood routine,24-hour urinary protein and other clinical data of the two groups were collected,and the clinical symptoms were asked in detail for SLEDAI score.Finally,the adverse in the both group were recorded.4.The statistical software SPSS20.0 is used to analyze the data studied.Results1.There was no significant difference in sex and age between SLE group and healthy control group(Healthy controls,HC).2.The number of total T,total B,NK,CD4~+T and CD8~+T cells in peripheral blood in SLE group was lower than that in HC group(P<0.05).Compared with CD4~+T cell subsets in HC group,the number of Th1 cells in SLE group was higher than that in HC group(P<0.05).The number of Treg cells in SLE group was lower than that in HC group(P<0.05),but there was no difference in the number of Th2 and Th17 cells between the two groups.The ratios of Th1 to Th2 and Th17 to Treg in SLE group were higher than those in HC group(P<0.05).The cytokines IL-2,IL-4,IL-6,IL-10,IL-17,TNF-?and IFN-?in SLE group were higher than those in HC group(P<0.05).3.Compared with the non-purging group,the number of total T,total B,NK,CD4~+T and CD8~+T cells in the immunologic purging group was higher than that in the non-purging group at the 0,1,12,24 and 36 week of treatment,while the number of Th1 cells was lower than that in the non-purging group.The number of Treg cells in the immunologic purging group was higher than that in the non-purging group.There was no difference in the number of Th2 and Th17 cells.4.There was no significant difference in cytokines IL-2,IL-4,IL-6,IL-10,IL-17,TNF-?and IFN-?between the immunologic purging group and the non-purging group at different time points(0,1,12,24 and 36 weeks of treatment).5.There were significant differences in ESR,complement,anti-ds-DNA antibody,blood routine,24-hour urinary protein and SLEDAI scores between the immunologic purging group and the non-purging group at different time points(0,1,12,24,36 week).The ESR,complement,anti-ds-DNA antibody,24-hour urinary protein and SLEDAI scores of the immunologic purging group were lower than those of the non-purging group.The counts of WBC,Hb and PLT were higher than those in the non-purging group(P<0.05).Conclusions1.There is an imbalance between Th1/Th2 and Th17/Treg in SLE patients,which is characterized by an increase in the number of Th1 cells and a decrease in the number of Treg cells.2.Immunologic purging therapy can balance Th1/Th2 and Th17/Treg in SLE patients.3.Immunologic purging therapy therapy is effective in patients with SLE and can improve the prognosis. |
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