The Change Of T Cell Subsets In Systemic Lupus Erythematosus Patients

Objective: To investigate the level of T cell subsets in systemic lupuserythematosus (SLE) patients in different active stages, and the relationship betweenthe ration of CD4~+/CD8~+ T cells in active SLE patients and other clinical or laboratoryfindings. Then try to explore the clinical importance of T cell subsets in thepathogenesis, and if T cell subsets may be of valuable as reference in evaluatingconditions and instructing treatment of SLE.Methods: forty high active SLE patients, twenty-six low active SLE patients,fifteen stable SLE patients and thirty healthy controls were enrolled. The percentageof CD4~+,CD8~+ T cells and the ration of CD4~+/CD8~+ T cells in peripheral blood ofSLE patients and controls were tested with flow cytometry. The clinical andimmunological findings of all the SLE patients were recorded. Statistic analysis wasmade to explore the relationship between them.Results:(1) The percentage of CD4~+ T cells and the ration of CD4~+/CD8~+ T cells inperipheral blood of high active SLE patients were much lower than that in healthycontrols (p＜0.01); the percentage of CD8~+ T cells was much higher than that inhealthy controls (p＜0.01). The percentage of CD4~+ T cells and the ration ofCD4~+/CD8~+ T cells in peripheral blood of stable SLE patients were lower than that inhealthy controls (p＜0.05); the percentage of CD8~+ T cells was higher than that inhealthy controls (p＜0.05).(2) The percentage of CD4~+ T cells in peripheral blood of high active SLEpatients was lower than that in stable SLE patients (p＜0.05); the ration of CD4~+/CD8~+T cells was much lower than that in stable SLE patients (p＜0.01); The percentage ofCD8~+ T cells was much higher than that in stable SLE patients (p＜0.01).(3) In active SLE patients, there was a negative correlation between the ration of CD4~+/CD8~+ T cells in peripheral blood and SLEDAI score (r=-0.331, p=0.040＜0.05).There was a negative correlation between the ration of CD4~+/CD8~+ T cells inperipheral blood and urine protein (r=-0.332, p=0.039＜0.05). There was a positivecorrelation between the ration of CD4~+/CD8~+ T cells in peripheral blood and C3.There was no correlation between the ration of CD4~+/CD8~+ T cells in peripheral bloodand other laboratory parameters, such as IgG, CIC, ESR, WBC and PLT.(4) There were no significant differences between the percentage of CD4~+, CD8~+T cells and the ration of CD4~+/CD8~+ T cells in peripheral blood of active SLE patientshad treated with corticosteroids for two weeks and before treatment (p＞0.05), butSLEDAI score decreased to eight score.Conclusion:(1) The percentage of CD4~+ T cells and the ration of CD4~+/CD8~+ T cells inperipheral blood of high active SLE patients and stable SLE patients were lower thanthat in healthy controls (p＜0.01 or p＜0.05); the percentage of CD8~+ T cells was higherthan that in healthy controls (p＜0.01 or p＜0.05), which suggested the level of T cellsubsets was abnormal in active and stable SLE patients, it had involved in thepathology of SLE.(2) In active SLE patients, the percentage of CD4~+ T cells in peripheral bloodwas lower than stable SLE patients (p＜0.05); the ration of CD4~+/CD8~+ T cells wasmuch lower than stable SLE patients (p＜0.01); the percentage of CD8~+ T cells wasmuch higher than stable SLE patients (p＜0.01). There was a negative correlationbetween the ration ofCD4~+/CD8~+ T cells and SLEDAI score, which suggested T cellsubsets may be of valuable as reference in evaluating the conditions of SLE.(3) In active SLE patients, there was a negative correlation between the ration ofCD4~+/CD8~+ T cells in peripheral blood and urine protein (r=-0.332, p=0.039＜0.05).There was a positive correlation between the ration of CD4~+/CD8~+ T cells inperipheral blood and C3, which suggested the ration of CD4~+/CD8~+ T cells hadinvolved in the immunity and inflammatory reaction of SLE, especially kidney damage.(4) There were no significant differences between the percentage of CD4~+, CD8~+T cells and the ration of CD4~+/CD8~+ T cells in peripheral blood of active SLE patientshad treated with corticosteroids for two weeks and before treatment (p＞0.05), butSLEDAI score decreased to eight score, which suggested corticosteroids couldn'tinfluence above-mentioned numerus, it may be influence their function to decreaseSLEDAI score, so the above-mentioned numerus may not be of valuable as referenceto evaluate the therapeutical effect.