Changes in immune cell frequencies after cyclophosphamide or mycophenolate mofetil treatments in patients with systemic lupus erythematosus

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• 作者：Ling Zhao (1) zhaoling52@163.com
  Zhenyu Jiang (1) jiangzhenyu2012@yeah.net
  Yanfang Jiang (2) yanfangjiang@hotmail.com
  Ning Ma (1) britty1314@163.com
  Kai Wang (1) kaikai5413@sina.com
  Yandong Zhang (1) zhangyd78@sina.com
• 关键词：Cyclophosphamide &#8211 ; Lymphocyte subsets &#8211 ; Mycophenolate mofetil &#8211 ; Systemic lupus erythematosus
• 刊名：Clinical Rheumatology
• 出版年：2012
• 出版时间：June 2012
• 年：2012
• 卷：31
• 期：6
• 页码：951-959
• 全文大小：381.9 KB
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• 作者单位：1. Department of Rheumatology, First Hospital, Jilin University, Changchun, 130021 China2. Department of Central Laboratory, the Second Part of First Hospital, Jilin University, Changchun, China
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Rheumatology
  
• 出版者：Springer London
• ISSN：1434-9949

文摘

This study was designed to explore the profile of immune cell subsets, including T, B, natural killer (NK), and NKT cells, in systemic lupus erythematosus (SLE) patients, and to determine their relationships with the clinical index and the effects of cyclophosphamide (CYC) and mycophenolate mofetil (MMF) treatment. SLE patients (n = 28) and age/sex-matched healthy controls (n = 28) were evaluated. The patients were equally divided into two treatment groups: intravenous drip (IVD) with CYC and prednisolone, and oral MMF and IVD with prednisolone. SLE peripheral blood samples were taken immediately prior to treatment and after 4 weeks of drug treatment. T, B, NK, and NKT cell subsets were measured by flow cytometry. Double-stranded DNA antibody and Sm antibody were detected by indirect immunofluorescence. Serum C3, C4, and C-reactive protein were determined by scatter turbidimetry. The percentages of CD3+CD4+ T, CD3&#8211;CD16CD56+ NK, and CD3+CD16CD56+ NKT cells and the CD4+/CD8+ ratio were significantly lower in SLE patients, while CD3+CD8+ T and CD3&#8211;CD19+ B cells were higher than the controls. The lymphocyte subsets were significantly correlated with the SLE disease activity index (SLEDAI) and complement factors (C3, C4). Four weeks of CYC or MMF treatment led to a significant increase in CD3+CD4+ T cells (P < 0.05). In addition, both CYC and MMF treatments led to increases in CD3+ T and CD3&#8211;CD16CD56+NKT cells and decreases in CD3&#8211;CD16CD56+ NK and CD3+CD8+ T cells, but these changes were not obvious. The significant correlation that exists between lymphocytes subsets and SLEDAI activity scores suggests that the lymphocyte subsets may reflect SLE severity. Our results indicate that both the traditional cyclophosphamide agent and the new mycophenolate mofetil agent can regulate the lymphocyte subsets and consequent abnormal immunity, suggesting that MMF, which is known to produce less side-effects than CYC, may be used as an effective treatment of SLE.