| Objective:To observe the levels and differences of peripheral blood lymphocyte subsets in patients with primary Sj(?)gren’s syndrome(p SS)before and after treatment with short-term low-dose IL-2 and/or rapamycin,and at follow-up of 12 and 24 weeks.Methods:60 p SS patients were collected as research subjects(20 patients treated with IL-2 were in group A,20 patients treated with rapamycin were in group B,20 patients treated with the combination of the two were in group C),and 60 healthy subjects(the healthy control group,HC group).General basic data including gender and age were collected as well as Peripheral blood lymphocyte subsets and laboratory data [erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)] before(0 week)and after(1 week)short-term low-dose IL-2 treatment(50WIU,subcutaneous injection *5 days)and/or rapamycin treatment(0.5mg,oral administration every other day)and at 12 and 24 weeks of follow-up.Mann-Whitney U test,Friedman M test and Spearman rank correlation analysis were used for statistical analysis.Results:1.The gender composition of p SS patients was more female than male(t=-1.036,P<0.05),body mass index(BMI)was higher than that of healthy control group(t=-3.063,P< 0.01),ESR was higher than that of healthy control group(t=-5.915,P<0.01),CRP was higher than that in healthy control group(t=-2.519,P< 0.01).2.Compared with the healthy control group,the absolute numbers of T,B,CD4+T,CD8+T,NK,Th2,Th17 and Treg cells were significantly decreased in p SS case group,and Th1/Th2 cell level was significantly increased,but Th1 and Th17/Treg cells had no significant differences.The absolute number of Th17 cells in p SS patients [2.88(1.88,9.05)/ul] was lower than that of the control group [5.69(4.16,8.61)/ul](Z=-3.391,P=0.001).The absolute number of Treg cells [14.96(10.19,22.33)/ul] was lower than that of the control group [32.99(24.54,45.86)/ul](Z=-6.293,P< 0.001).3.The absolute number of Th17 cells in p SS patients was negatively correlated with ESR(r=-0.412,P=0.001)and CRP(r =-0.427,P=0.001).The absolute number of Treg cells was not correlated with ESR and CRP,while Th17/Treg was negatively correlated with CRP(r =-0.374,P=0.003),no correlation with ESR(r=-0.083,P=0.526).4.After 1 week of treatment,ESR and CRP in group A were significantly lower than before(Z=-3.394,P=0.001)(Z=-2.092,P= 0.042).There were no significant differences in ESR and CRP in group B.In group C,ESR and CRP were significantly lower than before(Z=-2.305,P=0.021)(Z=-3.924,P<0.001).5.After 1 week of treatment,T,B and CD8+T cells in the three groups were significantly increased compared with 0 week,CD4+T cells were also significantly increased in group A and C,NK cells were also significantly increased in group A and B,and most of the elevated lymphocyte subsets at week 12 and 24 were significantly decreased compared with 1 week of treatment.After 1 week of treatment,the absolute numbers of Th17 and Treg cells in group A and C were significantly higher than 0 week,and Treg cells at 12 and 24 weeks were significantly lower than 1 week of treatment.6.The levels of Th17/Treg cells in group B were significantly higher than that in group C after 1 week of treatment,the levels of Treg and Th17/Treg cells in group B were significantly higher than that in group C after 12 weeks,and the levels of all lymphocyte subsets at 0 week and 24 weeks in the three groups had no significant differences.Conclusion:1.The changes in the number of Th17 and Treg cells,and the imbalance of Th17/Treg ratio may be involved in the progression of p SS,especially the autoimmune tolerance deficiency caused by the sharp decrease of Treg cells.2.After 1 week of treatment,ESR and CRP were significantly decreased in group A and C,but not in group B.At week 1 and 12,Th17/Treg cell level in group B was significantly higher than that in group C,and as the three groups performed well in different ways,no superior treatment was found among the three groups. |
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