Research Article
BibTex RIS Cite

Sistemik Lupus Eritematozuslu Aktif ve İnaktif Hastalarda T-Regulatuvar Hücreler Farklılık Gösteriyor mu?

Year 2020, Volume: 42 Issue: 3, 258 - 263, 27.05.2020
https://doi.org/10.20515/otd.463208

Abstract

Sistemik
lupus eritematozus (SLE) patogenezinde bozulmuş T yardımcı hücre (Th) alt
gruplarının ve düzenleyici T hücrelerinin (T-reg'ler) dengesizliği söz
konusudur. Otoantijenlere karşı oluşacak immun yanıtı baskılayarak otoimmun
hastalıkları engellemektedirler. Çalışmaların çoğunda periferal T-reg
hücrelerinin aktif hastalıkta azaldığı gösterilmişse de arttığı veya etkili
olmadığını gösteren çalışmalar da vardır. Amacımız, aktif ve inaktif SLE
hastalarında T-reg ve Th-17 düzeyleri açısından fark olup olmadığını saptayarak
hastalık patogenezi üzerine bu hücrelerin etkilerini ortaya koymaktır. Çalışmaya aktif, enfeksiyon bulgusu olmayan 21 SLE hastası alındı. Organ ve
sistem tutulumları, hemogram sonuçları, hastalık aktivasyonu açısından
eritrosit sedimentasyon hızı (ESH), C-reaktif protein (CRP), kompleman (C)3,
C4, anti-ds-DNA düzeyleri, SLE-hastalık aktivite indeksi (SLEDAI) değerleri
kaydedildi. SLEDAI≥6 aktif hastalık olarak kabul edildi. Eş zamanlı periferik
kandan Th-17 ve T-reg düzeyleri çalışıldı. Cinsiyet ve yaş uyumlu sağlıklı 15
kişi kontrol grubu olarak alındı. Hastaların 19’u kadın, yaş ortalaması 37.3±12.9,
hastalık süresi ortalama 7.9±1.29 yıl idi. Hastaların 15’inde (%71.4)
hematolojik, 17’sinde (%81) renal ve 7’sinde (%42.9) eklem tutulumu vardı.
CD4+CD25+ T-reg, CD4+FOXP3+T-reg, CD4+CD25+FOXP3+T-reg ve CD4+IL-17+ açısından
SLE ile sağlıklı kontrol grubu karşılaştırıldığında hem T-reg hücrelerinin hem
de CD4+IL-17+ hücre düzeyleri SLE grubunda anlamlı olarak daha yüksek saptandı
(sırasıyla p değerleri p=0.011, p=0.001, p=0.001 ve p=0.040). Hastalar
SLEDAI’ye göre aktif (n=12) ve inaktif (n=9) olarak karşılaştırıldığında 2 grup
arasında Th-17 ve T-reg düzeyleri açısından da anlamlı bir fark saptanamadı.
Ancak inaktif dönemde aktif döneme göre CD4+FOXP3+T-reg ve CD4+CD25+FOXP3+T-reg
hücrelerinin düzeyi artış eğilimindeydi.
Literatürde SLE’de T-reg çalışmalarının sayısı azdır ve sonuçlar
çelişkilidir. Çalışmaların çoğunda T-reg’lerin sayısının azaldığı ve
fonksiyonunun bozulduğu ve tedavi ile de bu hücrelerin artış eğiliminde
oldukları saptanmıştır. Sonuç olarak, çalışmamızda SLE’li hastalarda bütün
hastalar tedavi altında olduğundan T-reg hücreleri uyarılmış olabilir ve
kontrol grubundan daha yüksek düzeyler saptanmış olabilir. Bu durumu
açıklayabilmek için SLE’li immunsupresif naif hasta grubunda tedavi öncesi,
sonrası ve aktivasyon ve remisyon dönemlerinde hasta sayılarının fazla olduğu
benzer bir çalışma yapılmasına gereksinim vardır.

References

  • 1. Tsokos G.C. Mechanisms of disease: systemic lupus erythematosus N Engl J Med 2011;22:2110-21212. Kleczynska W, Jakiela B, Plutecka H, et al. Imbalance between Th17 and regulatory T-cels in systemic lupus erythematosus. Folia Histochem Cytobil 2011;49:646-6533. Abraham DJ, Krieg T, Distler J, et al. Overview of pathogenesis of systemic sclerosis. Rheumatology 2009;48:3-74. Uskudar Cansu D. Uskudar Teke H, Korkmaz C. Assessment Of Peripheral Blood Regulatory T Cells And T Helper 17 Cells In Patients With Systemic Scleroderma, Osmangazi Journal of Medicine 2018; 40 (1):28-33 Doi: 10.20515/otd.3958945. Alunno A, Carubbi F, Bistoni O, Caterbi S, Bartoloni E, Mirabelli G, Cannarile F, Cipriani P, Giacomelli R, Gerli R. T Regulatory and T Helper 17 Cells in Primary Sjögren's Syndrome: Facts and Perspectives. Mediators Inflamm. 2015;2015:243723. doi: 10.1155/2015/243723. Epub 2015 Apr 28. Review.6. Hemdan NY, Birekenmeier G, Wichmann G et al. Interleukin-17- producing T helper cells in autoimmunity. Autoimun Rev 2010;9:785-7927. Miossec P, Korn T, Kuchroo VK. Interleukin-17 and type 17 helper T cells. N Engl J Med 2009;36:888-8898. Buckner JH. Mechanisms of impaired regulation by CD4(+)CD25(+)FOXP3(+) regulatory T cells in human autoimmune diseases. Nat Rev Immunol 2010;10:849-8599. Alunno A, Bartoloni E, Bistoni O, Nocentini G, Ronchetti S, Caterbi S, Valentini V, Riccardi C, Gerli R. Balance between regulatory T and Th17 cells in systemic lupus erythematosus: the old and the new. Clin Dev Immunol. 2012;2012:823085. doi: 10.1155/2012/823085. Epub 2012 Jun 10. Kuhn A, Beissert S, Krammer PH. CD4+CD25+ regulatory T cells in human lupus erythematosus. Arch Deramtol Res 2009; 301:71-81.11. Yang J, Yang X, Zou H, Chu Y, Li M. Recovery of the immune balance between Th17 and regulatory T cells as a treatment for systemic lupus eryhthematosus. Rheumatology 2011;50:1366-1372.12. Klecyzynska W, Jakiela B, Plutecka H, Milewski M, Sanak M, Musial J. Imbalance Tn17 and regulatory T-cells in systemic lupus erythematosus. Folia Histochemica et Cytobiologica 2011;49:646-653.

Are Regulatory T Cell Levels Different in Active and Inactive Systemic Lupus Erythematosus Patients?

Year 2020, Volume: 42 Issue: 3, 258 - 263, 27.05.2020
https://doi.org/10.20515/otd.463208

Abstract

In the pathogenesis of systemic lupus erythematosus (SLE), impaired T
helper cell (Th) subgroups and regulatory T cells (T-reg) are imbalanced. It
suppresses the immune response to autoantigens and prevents autoimmune
diseases. Although most of the studies have shown that the majority of
peripheral T-reg cells are reduced in active disease, there are also studies
showing that they are either elevated or not effective. Our aim is to determine
whether there is a difference between T-reg and Th-17 levels in active and
inactive SLE patients and to demonstrate the effects of these cells on disease
pathogenesis. 21 SLE patients without active infection were included.
Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement (C)3,
C4, anti-ds-DNA levels, SLEDAI values were recorded in terms of organ and
system involvement, hemogram results, disease activation. SLEDAI≥6 were
considered active disease. Concurrent peripheral blood Th-17 and T-reg levels
were studied. 15 healthy control subjects were included in the study. 19 of the
patients were women, the mean age was 37.3 ± 12.9 years and mean duration of
disease was 7.9 ± 1.29 years. Hematologic involvement was present in 15 (71.4%)
of the patients, renal involvement in 17 (81%) and joint involvement in 7
(42.9%). Both T-reg cells and CD4+IL17+ cell levels were significantly higher
in SLE group compared to SLE in terms of CD4+CD25+
T-reg,
CD4+FOXP3+T-reg, CD4+CD25+FOXP3+T-reg (p=0.011, p=0.001, p=0.001 and p=0.040,
respectively). When the patients were compared according to SLEDAI as active (n=
12) and inactive (n=9), there was no significant difference between the two
groups in terms of Th17 and T-reg levels. However, in the inactive period, the
levels of CD4+FOXP3+T-reg and CD4+CD25+FOXP3+Treg cells tended to increase
compared to the active period. In the literature, the number of T-reg
studies in SLE is small and the results are contradictory. In the majority of
studies, it was determined that the number of T-regs decreased and that the
function deteriorated and that these cells were in an increasing tendency with
treatment. In conclusion, in our study, all patients with SLE were under
treatment and the T-reg cells could be stimulated and higher levels than the
control group could have been detected. In order to explain this situation, a
similar study is needed in pre-treatment, post-treatment, and activation and
remission periods in patients with SLE immunosuppressive naive patients with
more patient numbers.

References

  • 1. Tsokos G.C. Mechanisms of disease: systemic lupus erythematosus N Engl J Med 2011;22:2110-21212. Kleczynska W, Jakiela B, Plutecka H, et al. Imbalance between Th17 and regulatory T-cels in systemic lupus erythematosus. Folia Histochem Cytobil 2011;49:646-6533. Abraham DJ, Krieg T, Distler J, et al. Overview of pathogenesis of systemic sclerosis. Rheumatology 2009;48:3-74. Uskudar Cansu D. Uskudar Teke H, Korkmaz C. Assessment Of Peripheral Blood Regulatory T Cells And T Helper 17 Cells In Patients With Systemic Scleroderma, Osmangazi Journal of Medicine 2018; 40 (1):28-33 Doi: 10.20515/otd.3958945. Alunno A, Carubbi F, Bistoni O, Caterbi S, Bartoloni E, Mirabelli G, Cannarile F, Cipriani P, Giacomelli R, Gerli R. T Regulatory and T Helper 17 Cells in Primary Sjögren's Syndrome: Facts and Perspectives. Mediators Inflamm. 2015;2015:243723. doi: 10.1155/2015/243723. Epub 2015 Apr 28. Review.6. Hemdan NY, Birekenmeier G, Wichmann G et al. Interleukin-17- producing T helper cells in autoimmunity. Autoimun Rev 2010;9:785-7927. Miossec P, Korn T, Kuchroo VK. Interleukin-17 and type 17 helper T cells. N Engl J Med 2009;36:888-8898. Buckner JH. Mechanisms of impaired regulation by CD4(+)CD25(+)FOXP3(+) regulatory T cells in human autoimmune diseases. Nat Rev Immunol 2010;10:849-8599. Alunno A, Bartoloni E, Bistoni O, Nocentini G, Ronchetti S, Caterbi S, Valentini V, Riccardi C, Gerli R. Balance between regulatory T and Th17 cells in systemic lupus erythematosus: the old and the new. Clin Dev Immunol. 2012;2012:823085. doi: 10.1155/2012/823085. Epub 2012 Jun 10. Kuhn A, Beissert S, Krammer PH. CD4+CD25+ regulatory T cells in human lupus erythematosus. Arch Deramtol Res 2009; 301:71-81.11. Yang J, Yang X, Zou H, Chu Y, Li M. Recovery of the immune balance between Th17 and regulatory T cells as a treatment for systemic lupus eryhthematosus. Rheumatology 2011;50:1366-1372.12. Klecyzynska W, Jakiela B, Plutecka H, Milewski M, Sanak M, Musial J. Imbalance Tn17 and regulatory T-cells in systemic lupus erythematosus. Folia Histochemica et Cytobiologica 2011;49:646-653.
There are 1 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Hava Üsküdar Teke 0000-0002-4434-4580

Döndü Üsküdar Cansu 0000-0001-6543-3905

Cengiz Bal 0000-0002-1553-2902

Cengiz Korkmaz 0000-0003-2679-0699

Publication Date May 27, 2020
Published in Issue Year 2020 Volume: 42 Issue: 3

Cite

Vancouver Üsküdar Teke H, Üsküdar Cansu D, Bal C, Korkmaz C. Sistemik Lupus Eritematozuslu Aktif ve İnaktif Hastalarda T-Regulatuvar Hücreler Farklılık Gösteriyor mu?. Osmangazi Tıp Dergisi. 2020;42(3):258-63.


13299        13308       13306       13305    13307  1330126978