The Relationship Between Serum 25-Hydroxy Vitamin D Levels And Lymphocyte Subsets In Patients With Systemic Lupus Erythematosus

Objective: Systemic lupus erythematosus(SLE)is a kind of autoimmune disease,which is manifested by immune inflammation.At present,it is considered that the pathogenesis of SLE is related to the environment,heredity,hormone level and immune abnormality,but the specific mechanism has not been fully clarified.Patients with SLE produce a large number of autoantibodies,in addition,there are immune cells,cytokines and other immune abnormalities.Vitamin D,as a nerve-endocrine-immune regulating hormones,combined with vitamin D receptor(VDR)to play effect on antigen-presenting cells,T cells,B cells and other immune cells,regulating immune cell proliferation and differentiation,inflammatory cytokines and immunoglobulin expression.It is reported vitamin D deficiency be related to a variety of autoimmune diseases,such as multiple sclerosis(MS),type 1 diabetes mellitus(T1DM),inflammatory bowel disease(IBD),rheumatoid arthritis(RA),SLE,and prompt it may be interrelated the pathogenesis of autoimmune diseases.Abnormal levels of Vitamin D and lymphocyte subsets were common in patients with SLE.The level of serum 25(OH)D3 and lymphocyte subsets in peripheral blood of primordial SLE patients and healthy controls were tested.There was significant relationship between 25(OH)D3 and lymphocyte subsets and clinical significance.Vitamin D may play somewhat roles the pathogenesis of SLE.Methods: The serum levels of 25-hydroxy vitamin D were detected by chemiluminescence immunoassay in 31 patients with primordial SLE and 21 healthy controls.Flow cytometry was used to detect the percentage of CD3+T cells,CD3+CD4+Th cells,CD3+CD8+Ts cells,Th/Ts,CD19+B cells,and CD3-CD16+56+NK cells in peripheral blood of 31 patients with primordial SLE and 21 the healthy controls.There was correlation of 25-OH-vitamin D levels in patients with SLE and systemic lupus erythematosus disease activity index(SLEDAI),lymphocyte subsets,respectively.Results: 1 The level of 25(OH)D3 in the SLE group were lower than the control group [(10.19±3.94)ng/ml and(14.11±3.62)ng/ml,t=-3.63,P<0.05].2 According to the SLEDAI score,25(OH)D3 was obviously lower in the active group than that in the healthy control group [(7.05±2.39)ng/ml and(14.11±3.62)ng/ml,P<0.05],and that was also obviously lower in the active group than that in the inactive group [(7.05±2.39)ng/ml and(12.46±3.25)ng/ml,P<0.05].However,there was not difference between in the inactive group and healthy control group[(12.46±3.25ng/ml and 14.11±3.62ng/ml,P>0.05].3 There was no difference in the percentage of CD3+T cells in peripheral blood between SLE patients and the control groups[(69.54±8.73)% and(71.31±6.33)%,t=-0.80,P>0.05],[(71.82±7.85)% and(71.31±6.33)%,t=0.23,P>0.05],[(66.39±9.21}% and(71.31±6.33)%,t=-1.85,P>0.05],[(66.39±9.21)% and(71.82±7.85)%,t=1.77,P > 0.05],respectively.The percentage of CD3+CD4+Th cells,Th/Ts,CD3-CD16+56+NK cells in SLE patients was lower than that of control group [(28.48±8.13)% and(40.64±5.04)%,t=-6.10,P < 0.05],[0.80(0.50,1.03)and 1.50(1.20,1.79),Z=-4.9,P<0.05],[(5.77±3.17)% and(12.20±2.50)%,t=-7.80,P<0.05],respectively,while CD3+CD8+Ts cell,CD19+B cell higher than control group [(38.61±10.07)% and(28.62±4.51)%,t=4.85,P<0.05],[(19.70±7.90)% and(11.01±3.81)%,t=5.28,P<0.05].4 The percentage of CD3+CD4+Th cells,Th/Ts,CD3-CD16+56+NK cell in inactive group was lower than that of control group [(33.45±6.44)% and(40.65±5.04)%,t=-3.91,P<0.05],[1.01(0.75,1.18)and 1.50(1.20,1.79),Z=-3.73,P<0.05],[(5.07±2.89)% and(12.20±2.50)%,t=-8.26,P<0.05],respectively,while CD3+CD8+Ts cell,CD19+B cell higher than control group [(35.12±8.02)% and(28.62±4.51)%,t=3.05,P<0.05],[(17.19±6.76)% and(11.01±3.81)%,t=3.58,P<0.05].5 The percentage of CD3+CD4+Th cells,Th/Ts,CD3-CD16+56+NK cell in active group was lower than that of control group[(21.59±4.26)% and(40.64±5.04)%,t=-11.33,P<0.05],[0.49(0.39,0.70)and 1.50(1.20,1.79),Z=-4.63,P<0.05],[(6.74±3.38)% and(12.20±2.50)%,t=-5.40,P<0.05],respectively,while the percentage of CD3+CD8+Ts cell,CD19+B cell higher than control group [(43.44±10.91)% and(28.62±4.51)%,t=4.66,P<0.05],[(23.17±8.29)% and(11.01±3.81)%,t=4.97,P < 0.05].6 There was no difference in the percentage of CD3-CD16+56+NK cells in peripheral blood between active group and inactive group [(6.74±3.38)% and(5.07±2.89)%,t=-1.48,P>0.05].The percentage of CD3+CD4+Th cells and Th/Ts in active group was lower than that of inactive group [(21.59±4.26)% and(33.45±6.44)%,t=5.77,P<0.05],[(0.49(0.39,0.70)and 1.01(0.75,1.18),Z=-3.39,P<0.05],while CD3+CD8+Ts cell,CD19+B cell higher than inactive group [(43.44±10.91)% and(35.12±8.02)%,t=-2.45,P<0.05],[(23.17±8.29)% and(17.19±6.76)%,t=-2.21,P<0.05].7 Patients with SLE were divided into two groups according to the ratio of Th/Ts,the level of 25(OH)D3 in inversion group was lower than the non inverted group [(9.07±3.94)ng/ml and(11.95±3.40)ng/ml,t=-2.09,P<0.05].8 Negative correlation was observed between 25(OH)D3 and SLEDAI(r=-0.545,P<0.05).Positive correlation was observed between 25(OH)D3 and CD3+CD4+Th cells(r=0.456,P=0.01)and between 25(OH)D3 and Th/Ts(r=0.477,P<0.05).However,there was not correlation between 25(OH)D3 and CD3+T cell,CD3+CD8+Ts cell,CD19+B cell,CD3-CD16+56+NK cell(P>0.05).Conclusion:1 The Decrease presence of 25(OH)D3 levels and the abnormal lymphocyte subsets in Patients with SLE,which can be used as an indicator of disease activity in SLE.2 Negative correlation was observed between serum 25(OH)D3 levels and the percentage CD3+CD4+Th cell,Th/Ts in patients with SLE,vitamin D may be related to the pathogenesis of SLE.