Peripheral blood Th17/Treg imbalance in patients with low-active systemic lupus erythematosus.

INTRODUCTION: The balance between proinflammatory Th17 cells and regulatory T cells plays an important role in the pathogenesis of autoimmune diseases, including systemic lupus erythematosus (SLE). In particular, an increased ratio of Th17/Treg cells has been shown to correlate with active SLE and specific organ involvement. The aim of our study was to assess Th17 and Treg cell populations in peripheral blood (PB) of patients with clinically quiescent SLE, and to evaluate their correlation with organ involvement. MATERIAL/METHODS: We performed flow cytometric analysis of studied T CD4+ cell subpopulations in PB from 21 patients with SLE and 13 healthy controls. Disease activity was measured with the SELENA-SLEDAI index; organ involvement was divided into renal, neurological and hematological. RESULTS: A statistically significant difference (p<0.01) between the mean percentages of CD4+CD25highFoxP3+ Treg cells in SLE patients (18.57%) and healthy controls (32.08%) was observed. Similarly, proportions of functional CTLA-4+ Treg cells were markedly lower in SLE patients than in healthy controls--19.3% vs. 23.82% (p=0.03). In contrast, SLE patients exhibited a significantly increased frequency of circulating Th17 cells with the phenotype CD4+IL-17+ compared to controls--1.36 % vs 0.19% (p<0.01). Also the ratio of Th17 cells to Th1 cells was markedly higher in SLE patients than in the control group (p<0.01). We did not find any correlation of PB Th cell distribution with organ involvement in SLE patients examined. CONCLUSIONS: Our report showed for the first time that systemic Th17/Treg imbalance occurred also in patients with low disease activity and in remission. We suggest that immunological alterations may precede clinical and laboratory symptoms of the disease activity.

Anti-ox-LDL antibodies and anti-ox-LDL-B2GPI antibodies in patients with systemic lupus erythematosus.

OBJECTIVES: The aim of the study was to assess the concentration of anti-oxidized low-density lipoprotein (anti-oxLDL) antibodies and antibodies against oxLDL-beta2GPI (oxLDL-beta 2 glycoprotein I) complexes in the serum of patients with systemic lupus erythematosus (SLE). Correlations between clinical and laboratory factors and the intima media thickness (IMT) were also investigated. MATERIAL AND METHODS: The study included 16 patients (14 females, 2 males) with an established diagnosis of SLE. The mean disease duration was 6.3 years (range: 2-23 years). Thirteen age-matched healthy volunteers comprised the control group. IMT, the concentration of anti-oxLDL and anti-oxLDL-beta2GPI antibodies and lipid profile were assesed. Data concerning other cardiovascular risk factors were also collected. RESULTS: In the SLE group the intima media was significantly thicker than in control group. In the SLE group a statistically significant positive correlation was noted between age and mean IMT. Immunological assays revealed elevated serum concentration of anti-oxLDL antibodies in the SLE group; serum concentration of IgG anti-oxLDL-beta2GPI antibodies and IgM anti-oxLDL-beta2GPI antibodies were also elevated in the SLE group compared to the controls. There was a statistically significant positive correlation between LDL concentration and anti-oxLDL antibody concentration in the SLE group. CONCLUSIONS: The study findings support the thesis that cardiovasular risk is significantly higher in SLE patients. Elevated concentrations of anti-oxLDL antibodies, IgG anti-oxLDL-beta2GPI antibodies and IgM anti-oxLDL-beta2GPI antibodies were detected in the SLE group, which may contribute to the elevated cardiovascular risk in SLE patients.