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Study of balance between T-helper 17 /T-regulatory cells in systemic lupus erythematosus and its relation to disease activity

Sheren Esam Maher*, Hanan Aly Taha, Walaa G. Hozayn, Ahmed Mohamed Okasha, Amer E Ahmed, Manar Ali Shata, Emad A. Abdel-Naem

Background and objectives: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that causes damage to many organs of the body. The balance between pro-inflammatory T-helper 17(Th17) and regulatory-T (Treg) cells play an important role in the pathogenesis of SLE. The aim of the study is to assess Th17/Treg ratio and their relation to disease activity in both adult and juvenile SLE patients on T -lymphocytes using flow cytometry.

Patients and methods: This study was carried out on 80 patients; 40 patients with adult SLE and 40 patients with juvenile SLE. Forty subjects were taken as control groups. All patients and control were subjected to history taking and measuring of Complete blood count (CBC), C3, C4, Antinuclear antibody (ANA), Anti ds-DNA and protein /creatinine ratio in urine and measurement of Th17 and Treg by flow cytometry.

Results: There was statistically significant increase in Th17/Treg ratio in both active adult and juvenile SLE when compared with inactive adult and juvenile SLE and control groups. Also there was statistically significant increase in Th17/Treg ratio in inactive juvenile SLE when compare with control, however, there was no significant difference between inactive adult SLE when compared with control groups. There was a significant positive correlation between Th17cells and SLEDAI, ANA, serum creatinine in both adult and juvenile SLE, Also,a significant positive correlation between Treg cells and absolute neutrophil count, platelets , C3 and C4 in both adult and juvenile SLE.

Conclusion: Th17/Treg ratio is increased in active adult and juvenile SLE when compared with inactive SLE and control and thus this ratio may be used as a marker of disease activity.