Study On The Correlation Between Lymphocyte Subsets And Systemic Lupus Erythematosus Disease Activity And Anti-BAFF/APRIL Efficacy

ObjectivesSystemic lupus erythematosus(SLE)is an autoimmune disease characterized by multiple autoantibodies(represented by antinuclear antibodies)and multiple organ involvement.Related studies have found that there are abnormalities in lymphocyte subsets in SLE patients:abnormal apoptosis of T cells,imbalance and dysfunction of helper T cells,and abnormal activation of B cells.Anti-BAFF/APRIL therapy reduces the production of autoantibodies by affecting the development and survival of mature B cells and plasma cells,thereby better controlling disease activity.At present,there are few studies on the correlation of lymphocyte subsets in SLE patients with antiBAFF/APRIL treatment,and there is no unified conclusion.The purpose of this study was to analyze the correlation between lymphocyte subsets and SLE disease activity and the efficacy of anti-BAFF/APRIL.SubjectsAccording to the inclusion and exclusion criteria,22 SLE patients treated with anti-BAFF/APRIL for 24 weeks in Nanfang Hospital of Southern Medical University from June 2020 to December 2022 were selected.MethodsRetrospectively collected 22 patients’ age,course of disease,clinical manifestations and related laboratory tests(including 24-hour urine protein,CRP,ESR,C3,C4,CH50,IgG,autoimmune antibody spectrum,etc.).Flow cytometry was used to detect T lymphocyte subsets and B lymphocyte subsets in SLE patients before and after treatment.According to the disease activity and efficacy,different levels were grouped.The changes of disease condition and lymphocyte subsets during treatment were analyzed to explore the correlation between lymphocyte subsets and disease activity and anti-BAFF/APRIL efficacy.Results1.The percentage of CD4+CD45RA suppressed T cells in SLEDAI≤4 group(18.62±1.35vs11.22±4.56)was significantly higher than that in SLEDAI>4 group(p<0.05).2.The percentage of CD3+CD4+T cells in SLE patients was negatively correlated with SLEDAI score(r=-0.585,p=0.014).3.The percentage of CD3 total T cells,the percentage of CD3+CD4+T cells,the absolute count of CD3+CD8+T cells,and the percentage of CD3-CD19+CD20+CD27+memory B cells were increased in SLE patients after treatment.The percentage and absolute count of CD3-CD19+B lymphocytes,the percentage and absolute count of CD3-CD19+CD20+CD27+initial B lymphocytes increased after treatment,and the difference was statistically significant(p<0.05).Conclusion1.Lymphocyte subsets were associated with SLE disease activity.The absolute count of CD3-CD19+CD20+CD27-initial B cells was higher in patients with severe activity,and the percentage of CD3+CD4+T cells was negatively correlated with SLEDAI.2.The efficacy of anti-BAFF/APRIL in SLE patients may be related to the changes of CD3 total T cells,CD3+CD4+T cells,CD3+CD8+T cells,CD3-CD19+CD20+CD27+memory B cells,CD3-CD19+B lymphocytes,CD3-CD19+CD20+CD27+initial B cells.