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AB0589 Relevance of b and t cell subsets to lupus flare in korean patients with systemic lupus erythematosus
  1. J.H. Koh1,
  2. N. Lee2,
  3. W.-U. Kim3
  1. 1Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan
  2. 2Center for Integrative Rheumatoid Transcriptomics and Dynamics, The Catholic University of Korea
  3. 3Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s hospital, the Catholic university of Korea, Seoul, Korea, Republic of Ireland

Abstract

Background Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with heterogeneous clinical manifestations and is characterised with autoreactive T cells and autoantibody overproduction by activated B cells.

Objectives The aims of this study were to characterised T-cell and B-cell subpopulation phenotype in Korean patients with SLE, and to elucidate the association between lymphocyte subpopulation and lupus activity.

Methods We used multicolor flow cytometry to analyse subsets of peripheral blood B-cells (defined by CD19, IgD, CD27, and CD38) and T-cells (CD3, CD4, CD8, CD45RA, CCR7) in 26 patients with SLE and 22 age- and sex-matched healthy subjects. Baseline and 6 month follow-up SLE disease activity index (SLEDAI) was recorded, and SLEDAI score ≥6 was considered as lupus flare-up. Lymphocyte phenotype was also compared between stable disease and lupus flare-up.

Results The number of B cells and CD8 +T cells were not different between SLE patients and healthy subjects; however, non-switched memory (NSwM) B cells was decreased in SLE patients. Double negative (DN) T cells, CD4 +T cells and its subset [naïve, central memory (CM), effector memory (EM) and terminally differentiated effector memory (TEMRA) cells] were decreased in SLE patients compared to healthy controls. Patients with lupus flare-up showed significantly decreased CD4 +and DN T cells, whereas CD4 +EM T cells were increased in patients with lupus flare up, compared to stable SLE. SLEDAI was correlated with DN T cells (ρ=−0.728, p<0.001), CD4 +CM T cells (ρ=−0.544, p=0.004), CD4 +EM T cells (ρ=−0.697, p<0.001) and CD8 +EM T cells (ρ=−0.408, p=0.039). Six (23%) patients experienced lupus flare and a patient presented still high disease activity at 6 month follow-up visit. Interestingly, these patients showed the low number of DN T cells, CD4 +EM and TEMRA cells at baseline when they were stable.

Conclusions Biassed differentiation of T-cells was associated with lupus flare and aggravation of SLE 6 months later. Understanding T cell subset enables accurate stratification of lupus flare-up and personalised approach.

References [1] Nakayamada S, Iwata S, Tanaka Y. Relevance of lymphocyte subsets to B cell-targeted therapy in systemic lupus erythematosus. Int J Rheum Dis2015;18:208–218.

[2] Anolik JH, Barnard J, Owen T, Zheng B, Kemshetti S, Looney RJ, et al. Delayed memory B cell recovery in peripheral blood and lymphoid tissue in systemic lupus erythematosus after B cell depletion therapy. Arthritis Rheum2007;56:3044–3056.

[3] Tsokos, G. C., M. S. Lo, P. C. Reis, and K. E. Sullivan. 2016. New insights into the immunopathogenesis of systemic lupus erythematosus. Nat Rev Rheumatol12: 716–730.

Acknowledgements We wish to thank Jihoon Kwon, the M.S. student for his excellent support.

Disclosure of Interest None declared

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