Changes In Peripheral T-lymphocyte Subsets And Serum Cytokines In Patients With Systemic Sclerosis

Objective:To investigate the changes of peripheral blood T lymphocyte subsets and serum cytokine levels in patients with systemic sclerosis(SSc),as well as the correlation of various clinical indicators and organ involvement,and to evaluate its diagnostic value.Methods:A total of 76 SSc patients enrolled,who visited the Rheumatology and Immunology Department of the Second Hospital of Shanxi Medical University from January 2018 to December 2020,and enrolled in the study were initial treatment.We also included 76 healthy controls(HCs),who visited the physical examination center of our hospital during the same period,were matched with SSc patients in age and gender.Demographic indicators(gender,age,disease course,etc.),clinical measurements(ESR,CRP,immunoglobulin,complement,autoantibody,etc.),peripheral blood lymphocyte count and cytokine levels were collected.The above indexes were different between SSc and HCs.To compare the correlation between T lymphocyte subsets and cytokines and inflammatory markers in the SSc group.The T lymphocyte subsets and cytokines of the involved components were compared according to the organ involvement group.ROC curve was used to analyze its diagnostic value.Mann-Whitney U test and Spearman rank correlation analysis were used for statistical analysis.Results:1.The absolute numbers of Th2 and Treg cells in SSc patients were lower than those in HCs(p < 0.05),resulting in the ratios of Th1/Th2 [25.01(12.24,38.61)vs11.64(6.38,20.34)] and Th17/Treg [0.42(0.17,0.66)vs 0.17(0.13,0.29)] were increased significantly(p < 0.001).The serum levels of IL-2,SIL-2R,IL-6,IL-10,IFN-γ,and TNF-α were significantly higher than those in HCs(p < 0.001).2.The absolute numbers of total T,Th,and Treg cells were negatively correlated with CRP(r =-0.406,p = 0.002;r =-0.263,p < 0.05;r =-0.367,p < 0.01).Increasing IL-2 in the wake of the augment of ESR(r = 0.671,p = 0.004),so did IL-6(r = 0.378,p < 0.05).3.The ratio of Th17/Treg in SSc-ILD patients had lower levels than that in other patients [0.35(0.14,0.53)vs 0.64(0.26,0.93),p =0.028];Treg cells were lessened in patients with Raynaud’s phenomenon relative to controls [3.00(2.41,4.28)vs 3.55(2.86,4.53),p < 0.05].The levels of IL-2,IL-10 and IFN-γ were elevated in patients with arthralgia [3.32(1.05,11.73)vs 2.32(0.44,6.45),p =0.045],[8.08(3.63,355.77)vs 4.89(0.78,21.44),p = 0.02],[6.31(2.66,44.03)vs 4.03(0.22,16.96),p = 0.009],while the level of Th17 was decreased [0.62(0.20,2.16)vs 1.26(0.22,10.93),p =0.026].4.ROC curve analysis yielded an optimal cut-off IL-2,IL-10,and IFN-γ levels of2.67,5.93,and 5.32 pg/ml for the presence of arthralgia.The combination of these three cytokines has a higher positive rate in the detection of SSc patients with joint involvement.Conclusion:We exhibited abnormalities in T subsets and the production of their cytokines in SSc,as compared with those in HCs.T lymphocyte subsets and cytokines were correlated with inflammatory indicators such as ESR and CRP.At the same time,which were also abnormal in patients with SSc such as pulmonary interstitial fibrosis,Raynaud’s phenomenon,and arthralgia.In addition,this study analyzed the diagnostic value of abnormal levels of cytokines using ROC curves.This may allow the pathogenesis of SSc and the development of novel therapeutic interventions aimed at targeting these cells and the cytokines they produce.