The evaluation of cellular immune function in elderly patients with systemic lupus erythematosus
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Background/Aims: To evaluate cellular immune function in systemic lupus erythematosus (SLE) patients over 60 years old, the association between antinuclear antibody (ANA) titers and the ratio of CD4+/CD8+ was analyzed in this study. The distribution of ANAs and extractable nuclear antibodies (ENAs) in a healthy elderly population was also investigated. Methods: Serum ANA titers were assayed by indirect immunofluorescence (IIF) and the CD4+/CD8+ T-cell ratio was determined by flow cytometry in 76 SLE patients and 30 healthy control individuals. IIF of cytoplasm and nuclear and nucleolar staining were performed on samples taken from 286 healthy elderly individuals. ENA levels were determined using a strip enzyme immunoassay among patients that tested positive for ANAs. Results: ANA titers were negative in the 30 control individuals, but were positive in the 76 SLE patients. Based on ANA titers, the SLE patients were stratified to low (≤ 1:320), medium (1:640 to 1:1,280), and high (≥ 1:2,560) titer groups. The average CD4+/CD8+ ratio of the SLE group was significantly lower than that of the control group. Among the 286 healthy elderly volunteers, 59 (20.63%) tested positive for ANAs. A homogeneous pattern was present in 47.46% of those 59 patients and a granule pattern in the karyoplasm was present in 33.90%. Furthermore, of the 59 patients, ENAs immunoassay was positive in 18 (30.51%); Sjogren syndrome-related antigen A (SSA)/52 kd and Sjogren syndrome antigen B (SSB)/La were the two major antibodies. Conclusions: The significantly lower CD4+/CD8+ ratio among SLE patients over 60 years old is associated with deregulated immune responses and the development of SLE. A low ANA titer (1:160) is common in healthy elders, emphasizing the importance of considering age when determining if the evaluation of ANA titers is to be included in autoimmune disease diagnosis.
Abstract
Background/Aims: To evaluate cellular immune function in systemic lupus erythematosus (SLE) patients over 60 years old, the association between antinuclear antibody (ANA) titers and the ratio of CD4+/CD8+ was analyzed in this study. The distribution of ANAs and extractable nuclear antibodies (ENAs) in a healthy elderly population was also investigated. Methods: Serum ANA titers were assayed by indirect immunofluorescence (IIF) and the CD4+/CD8+ T-cell ratio was determined by flow cytometry in 76 SLE patients and 30 healthy control individuals. IIF of cytoplasm and nuclear and nucleolar staining were performed on samples taken from 286 healthy elderly individuals. ENA levels were determined using a strip enzyme immunoassay among patients that tested positive for ANAs. Results: ANA titers were negative in the 30 control individuals, but were positive in the 76 SLE patients. Based on ANA titers, the SLE patients were stratified to low (≤ 1:320), medium (1:640 to 1:1,280), and high (≥ 1:2,560) titer groups. The average CD4+/CD8+ ratio of the SLE group was significantly lower than that of the control group. Among the 286 healthy elderly volunteers, 59 (20.63%) tested positive for ANAs. A homogeneous pattern was present in 47.46% of those 59 patients and a granule pattern in the karyoplasm was present in 33.90%. Furthermore, of the 59 patients, ENAs immunoassay was positive in 18 (30.51%); Sjogren syndrome-related antigen A (SSA)/52 kd and Sjogren syndrome antigen B (SSB)/La were the two major antibodies. Conclusions: The significantly lower CD4+/CD8+ ratio among SLE patients over 60 years old is associated with deregulated immune responses and the development of SLE. A low ANA titer (1:160) is common in healthy elders, emphasizing the importance of considering age when determining if the evaluation of ANA titers is to be included in autoimmune disease diagnosis.
참고문헌 (24)
- Wu H, "The real culprit in systemic lupus erythematosus : abnormal epigenetic regulation", Int J Mol Sci, 16, pp.11013~11033 (2015)
- Grammatikos AP, "Spleen tyrosine kinase(Syk)regulates systemic lupus erythematosus(SLE)T cell signaling", PLoS One, 8, pp.e74550~ (2013)
- Wu Y, "Double positive CD4+CD8+ T cells : key suppressive role in the production of autoantibodies in systemic lupus erythematosus", Indian J Med Res, 140, pp.513~519 (2014)
- Leuchten N, "Performance of antinuclear antibodies for classifying systemic lupus erythematosus : a systematic literature review and meta-regression of diagnostic data", Arthritis Care Res(Hoboken), 70, pp.428~438 (2018)
- Voigt J, "Automated indirect immunofluorescence evaluation of antinuclear autoantibodies on HEp-2 cells", Clin Dev Immunol, 2012, pp.651058~ (2012)
- Choi BY, "Characteristics of pleural effusions in systemic lupus erythematosus : differential diagnosis of lupus pleuritis", Lupus, 24, pp.321~326 (2015)
- Zhu J, "CD4 T cells : fates, functions, and faults", Blood, 112, pp.1557~1569 (2008)
- Zhang X, "Urinary trypsin inhibitor attenuates lipopolysaccharide-induced acute lung injury by blocking the activation of p38 mitogen-activated protein kinase", Inflamm Res, 60, pp.569~575 (2011)
- Suarez A, "Enrichment of CD4+ CD25high T cell population in patients with systemic lupus erythematosus treated with glucocorticoids", Ann Rheum Dis, 65, pp.1512~1517 (2006)
- Shiozawa S, "Pathogenesis of SLE and aiCD4T cell : new insight on autoimmunity", Joint Bone Spine, 79, pp.428~430 (2012)
- Kim JS, "IL-7Rαlow memory CD8+T cells are significantly elevated in patients with systemic lupus erythematosus", Rheumatology(Oxford), 51, pp.1587~1594 (2012)
- Xu A, "Caenorhabditis elegans mom-4is required for the activation of the p38 MAPK signaling pathway in the response to Pseudomonas aeruginosa infection", Protein Cell, 4, pp.53~61 (2013)
- Sonawale A, "Evaluation of the association between CD4, CD8 and CD25 cell counts and SLE in active disease and in remission", J Assoc Physicians India, 65, pp.37~42 (2017)
- Goropevsek A, "STAT5phosphorylation in CD4 T cells from patients with SLE is related to changes in their subsets and follow-up disease severity", J Leukoc Biol, 101, pp.1405~1418 (2017)
- Maeda N, "Relationship between CD4+", CD8+ T cell ratio and T cell activation in systemic lupus erythematosus, 1999, pp.28, 166~170
- Zhao L, "Changes in immune cell frequencies after cyclophosphamide or mycophenolate mofetil treatments in patients with systemic lupus erythematosus", Clin Rheumatol, 31, pp.951~959 (2012)
- Matsushita M, "Changes of CD4", CD8 ratio and interleukin-16 in systemic lupus erythematosus, 2000, pp.19, 270~274
- Wells JV, "In vivo anti-nuclear antibodies in epithelial biopsies in SLE and other connective tissue diseases", Clin Exp Immunol, 38, pp.424~435 (1979)
- Song LJ, "Analysis of 15 patients with systemic lupus erythematosus manifesting with negative immunofluorescence anti-nuclear antibodies after treatment", Lupus, 21, pp.919~924 (2012)
- Pawelec G, "Immunosenescence: impact in the young as well as the old?", Mech Ageing Dev, 108, pp.1~7 (1999)
- Boren E, "Inflamm-aging : autoimmunity, and the immune-risk phenotype", Autoimmun Rev, 3, pp.401~406 (2004)
- Satoh M, "Prevalence and sociodemographic correlates of antinuclear antibodies in the United States", Arthritis Rheum, 64, pp.2319~2327 (2012)
- Nilsson BO, "Antinuclear antibodies in the oldest-old women and men", J Autoimmun, 27, pp.281~288 (2006)
- Hurme M, "Autoimmunity and longevity : presence of antinuclear antibodies is not associated with the rate of inflammation or mortality in nonagenarians", Mech Ageing Dev, 128, pp.407~408 (2007)