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Measurement of natural (CD4+CD25high) and inducible (CD4+IL-10+) regulatory T cells in patients with systemic lupus erythematosus

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary

M. Aleksza

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary

T. Tarr

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary

S. Sipka

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary

G. Szegedi

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary

E. Kiss

Third Department of Internal Medicine, Medical and Health Science Centre, University of Debrecen, Hungary, kiss{at}iiibel.dote.hu or drkissemese{at}freemail.hu

Abnormalities of regulatory T cells may play an important role in the loss of self-tolerance, which is a major characteristic of lupus. The objective of this study was to determine the ratio and the number of natural CD4+CD25highFoxp3+ and inducible CD4+IL-10+ regulatory T cells in lupus patients and to search correlation with disease activity. Seventy-two Hungarian lupus patients were enrolled in the study. Fourty-one age- and sex matched healthy donors served as controls. Flow cytometry was used for the quantification of CD4+CD25high Foxp3+ (nTreg) and CD4+IL-10+ (iTreg) cells. The ratio (3.06 ± 1.45%) and the number (0.019 ± 0.012 x 109/L) of nTreg cells decreased in lupus significantly (P < 0.001 in both) as compared to normal controls (4.26 ± 1.01% and 0.039 ± 0.017 x 109/L). The ratio of iTreg cells were significantly higher in patients than in controls (20.92 ± 14.02% versus 15.49 ± 11.65%, P < 0.03), but the number of these cell type did not differ in significant manner (0.314 ± 0.236 x 109/L versus 0.259 ± 0.183 x 109/L). The 19 active patients were characterised by significantly higher disease activity index (SLEDAI 8.63 ± 2.95 versus 1.74 ± 1.68, P < 0.001) and anti-DNA concentration (117.85 ± 145.89 versus 37.36 ± 68.85 IU/mL, P = 0.001) as compered to the 52 inactive patients. Furthermore, active patients required higher dose of methylprednisolon than inactive ones (14.8 ± 10.6 versus 4.8 ± 3.4 mg/day, P < 0.001). However, we did not find statistical significant difference in the number and ratio of the examined cell populations regarding to disease activity. Altered ratio and number of both natural and inducible regulatory T cells may play a role in the pathogenesis of lupus. There are small but appreciable difference in the number of regulatory T cells between inactive patients and healthy controls. It suggests that immunoregulatory deficiencies are present in the inactive stage of the disease also. Lupus (2007) 16, 489—496.

Key Words: CD4+CD25high Foxp3+ • constitutional • IL-10 • inducible • regulatory T cells • SLE

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