Significance And Clinical Observation Of Treg Cells In Patients With Systemic Lupus Erythematosus

Objective:1.To compare the changes in peripheral blood CD4⁺T cell subset between SLE patients and healthy individuals;2.To analyze the correlation between Treg cell counts of patients with SLE and their age,duration,ESR and SLEDAI score;3.To compare the changes in peripheral blood CD4⁺T cell subset in patients with SLE before and after immunomodulatory therapy;4.To observe the efficacy of immunomodulatory drugs and traditional DMARDs in the treatment of SLE patients.Methods:A total of 62 SLE patients who were admitted to our hospital from January 2017 to June2017 were enrolled in the SLE group.The 56 healthy people who matched the gender and age of the SLE group at the same time were selected as the healthy control group.The absolute counts of CD4⁺T cell subsets in peripheral blood were detected by flow cytometry.The differences between the two groups were compared.The correlation between Treg cell counts in peripheral blood of SLE group and their age,duration,ESR and SLEDAI scores was analyzed.A total of 1580 patients with SLE admitted to our hospital from January 2008 to December 2018 were enrolled,including 720 patients with disease modifying anti-rheumatic drugs?DMARDs?who improved their condition as traditional DMARDs,and 860 patients used immunomodulatory drugs as immunomodulatory drug group.The main therapeutic drugs in the traditional DMARDs group include methotrexate,cyclophosphamide,mycophenolate mofetil,thalidomide,tacrolimus and leflunomide;the main therapeutic drugs for immunomodulatory drug group include IL-2,rapamycin,all-trans retinoic acid,metformin,coenzyme Q10 and vitamin A.Both groups were treated continuously for 1 year.Absolute counts of CD4⁺T cell subsets before and after treatment were measured in the immunomodulatory drug group,and the differences between the detected values were compared.The clinical symptoms,disease control and the dosage of glucocorticoid?here in after referred to as hormone?of the immunomodulatory drug group and the traditional DMARDs group were compared.Data analysis was performed using SPSS 20.0 software.A normal distribution of measurement data withx±S,using t-test.Measurement data that do not satisfy the normal distribution are represented by MD(P₂₅,P₇₅),using nonparametric test.The count data is expressed in terms of rate and using?² test.Correlation analysis was performed by Sperman test.P<0.05?two-sided?was considered statistically significant.Results:1.Compared with HC group,Th1,Th2,Th17 cells counts and Th1/Th2 in SLE group did not change,Treg cell counts decreased?P=0.003?,and Th17/Treg increased?P=0.003?.2.The Treg cell counts in peripheral blood of patients with SLE was negatively correlated with SLEDAI score?r=-0.288,P=0.046?.It was not related to age,duration,and ESR.3.Compared with pre-treatment?month 0?,the Treg cell counts in peripheral blood of patients with SLE were significantly increased in the 3rd,6th,and 12th month after immunomodulatory drug treatment?P<0.001?.4.Compared with the immunosuppressive group,the fever-regulating symptoms of the SLE patients in the immunomodulatory modulator group were decreased?P=0.044?,and there was no difference in the control of the disease between the two groups.The immunomodulator group used less glucocorticoids than the immunosuppressant group.?P<0.05?.Conclusion:1.The immune dysfunction in patients with SLE was mainly dued to the decrease in the number of Treg cells.2.The number of Treg cells in SLE patients was negatively correlated with SLEDAI score,indicating that the decrease in the number of Treg cells could cause disease activity.3.Immunomodulatory drugs could alleviate SLE to some extent by raising Treg cells.4.The immunomodulatory drugs were equivalent to the traditional DMARDs in the treatment of SLE,and the dosage of hormones used in combination with immunomodulatory drugs was less,indicating that the immunomodulatory drug treatment SLE did have certain clinical application value,which deserveed further study.