Peripheral CD4+ cell prevalence and pleuropulmonary manifestations in systemic lupus erythematosus patients

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• 作者：Krisztina Vincze^a ; ¹ ; Zsuzsanna Kovats^a ; ¹ ; Aron Cseh^b ; Krisztina Pasti^b ; Emese Kiss^c ; Anna Polgar^c ; Barna Vasarhelyi^b ; Attila J. Szabo^b ; Aniko Bohacs^a ; Lilla Tamasi^a ; Gyö ; rgy Losonczy^a ; Veronika Mü ; ller^a ; ^{mulver@pulm.sote.hu" class="auth_mail}
• 关键词：Systemic lupus erythematosus ; Lung ; Lung function ; T cells ; CD4+CD25hi+
• 刊名：Respiratory Medicine
• 出版年：May 2014
• 年：2014
• 卷：108
• 期：5
• 页码：766-774
• 全文大小：901 K

文摘

Systemic lupus erythematosus (SLE) is an autoimmune disease involving several organs, including the lungs. Previous results confirmed changes of peripheral T cell subsets in lupus patients; however no data are available about their possible relationship with pulmonary involvement.

Objective

To determine pulmonary manifestations and potential relationship in changes of peripheral CD4+ T cell subsets.

Methods

Patients with SLE (N = 28) were enrolled in complex pulmonary examination. Patients were divided into groups with pleuropulmonary manifestations (SLE_pulmN = 13 age: 44.9 ± 3.3 years, female: male = 11:2) or without (SLE_cN = 15 age: 27.2 ± 3.7 years, female: male = 12:3). Peripheral blood was taken for T helper (Th)1, Th2, Th17, CD4+CD25hi+ and regulatory T (Treg: CD4+CD25hi+ CD127−) cell analysis from SLE patients and healthy volunteers (controls, N = 40).

Results

SLE_pulm patients were older, had more pulmonary symptoms and significantly decreased pO₂ as compared to SLE_c group. Ventilatory disorder was present in 92% of SLE_pulm patients, with significantly decreased lung volumes, signs of airway involvement and decrease in DLco. Significant increase in Th1/Th2, while decrease in Th17/Treg ratios was present in all SLE compared to controls. In SLE_pulm CD4+CD25hi+ subset without changes in Treg number was significantly increased as compared to SLE_c and this subgroup of T cell showed significant positive correlation with dynamic lung function parameters and DLco (p < 0.05).

Conclusion

In lupus patients pleuropulmonary manifestations are prevalent and lung function and blood gas measurements should be regularly performed in the daily clinical assessment. Significant increase of activated CD4+CD25hi+ T cells, but not Treg is associated with decreased lung function parameters in SLE_pulm patients.