Expression And Significance Of Subsets Of Lymphocyte In The Patients With Systemic Lupus Erythematosus

Objective:1. To evaluate the count of lymphocyte and the ratio of neutrophil to lymphocyte(NLR) and platelet to lymphocyte ratio(PLY) in SLE patients;2. To compare the expression of the subsets of lymphocyte and discuss the correlation with SLEDAI score, disease course, ESR, C3 and C4.Methods:One hundred and forty-night participants were enrolled in the study, comprising 87 SLE patients, 78 with active disease(88.13 % female; mean age±SD, 34.79±13.88 years),28 patients in remission(96.42 % female; mean age±SD, 31.79±12.13 years), 16 patients in complete remission, 30 patients in partial remission and 25 age- and gendermatched controls(92.36 % female; mean age±SD, 32.46±9.87 years).The study protocol was approved by the local ethics committee, and all participants gave their signed informed consent. A convenience sample of 124 patients fulfilling the 1997 American College of Rheumatology classification criteria for SLE was recruited from Second Hospital of Shanxi Medical Collage. Patients were evaluated according to the SLE Disease Activity Index 2000(SLEDAI, 2 k), and classified as having active(SLEDAI 2 k≥5; n=78) and remission(SLEDAI 2 k<5; n=46);And according to clinical activity and serological activity classified patients in remission as complete remission and partial remission.The expression of the subsets of lymphocyte were detected by FCM. Analyze the expression of the subsets of lymphocyte in SLE and the correlation with SLEDAI score,disease course, ESR, C3 and C4.All the data were analyze with SPSS 17.0.Results:1.The count of lymphocyte was decreased in SLE patients as compared with those in healthy controls; NLR and PLR were increased in SLE patients as compared with those in healthy controls.2.The count of CD3+ T cell were decreased in SLE patients as compared with those in healthy controls(P<0.01), patients in active were decreased as compared with those in remission(P<0.001), patients in complete remission were increased as compared with those in partial remission(P<0.01); The count of CD56+CD16+ NK cell were decreased in SLE patients as compared with those in healthy controls(P<0.001), patients in active were decreased as compared with those in remission(P<0.01); The count of CD3+ T cell was negatively correlated with SLEDAI scores(r=-0.404, P=0.001) and ESR(r=-0.319,P=0.041) and positively correlated with C3(r=0.564,P=0.009). The count of CD19+ B cell was positively correlated with SLEDAI scores(r=0.363,P=0.002) and ESR(r=0.398,P=0.001). The count of CD56+CD16+ NK cell was negatively correlated with SLEDAI scores(r=-0.370,P=0.017).3.The count of CD4+ T cell were decreased in SLE patients as compared with those in healthy controls(P<0.001), patients in active were decreased as compared with those in remission(P<0.001), patients in complete remission were increased as compared with those in partial remission(P<0.01); The count of CD8+ T cell were decreased in SLE patients as compared with those in healthy controls(P<0.01), patients in active were decreased as compared with those in remission(P<0.001), patients in complete remission were increased as compared with those in partial remission(P<0.01); The ratio of CD4+ T cell to CD8+ T cell were decreased in SLE patients as compared with those in healthy controls(P<0.01); The count of CD4+ T cell was negatively correlated with ESR(r=0.417,P<0.001). The count of CD8+ T cell was negatively correlated with SLEDAI scores and ESR and was positively correlated with C3 and C4. The ratio of CD4+ T cell to CD8+ T cell was negatively correlated with C3.4.The count of Th1 cell were increased in SLE patients as compared with those inhealthy controls(P<0.001), patients in active were increased as compared with those in remission(P<0.05); The count of Th2 cell were increased in SLE patients as compared with those in healthy controls(P<0.001), patients in active were increased as compared with those in remission(P<0.05); The ratio of Th1 to Th2 cell was decrease in SLE patients as compared with that in healthy controls(P<0.01); The count of Th1 cell was negatively correlated with SLEDAI scores(r=-0.318,P=0.040); The count of Th2 cell was positively correlated with disease course(r=0.332,P=0.047); The count of Th17 cell were increased in SLE patients as compared with those in healthy controls(P<0.001), patients in active were increased as compared with those in remission(P<0.05); The count of Treg cell in SLE were decreased in in SLE patients as compared with that in healthy controls(P<0.001), patients in active were decreased as compared with those in remission(P<0.01); The ratio of Th17 to Treg cell were increased in SLE patients as compared with that in healthy controls(P<0.001), patients in active were increased as compared with those in remission(P<0.01); The count of Th17 cell was positively correlated with SLEDAI scores(r=0.272, P=0.024) and ESR(r=0.283,P=0.016). The count of Treg cell was negatively correlated with SLEDAI scores(r=-0.338,P=0.038). The ratio of Th17 cell to Treg cell was positively correlated with SLEDAI scores(r=0.299,P=0.013) and ESR(r=0.265,P=0.026).Conclusion:1.The subsets of lymphocyte were participate in the pathogenesis of SLE;2.The imbalanced of CD4+ and CD8+ Tcell, Th1 and Th2 cell, Th17 and Treg were involeved in SLE.