Associations of circulating CXCR3–PD-1+CD4+T cells with disease activity of systemic lupus erythematosus

Abstract

Objectives: Which helper CD4+ T cell subset contributes to autoantibodies generation and severity of end-organ involvement in lupus patients remains to be explored. Our research aims to investigate the roles of circulating Tfh (cTfh) cell subsets and corresponding CXCR5– Th cells in lupus patients and their correlation with SLE disease activity index 2000 (SLEDAI).Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from blood of systemic lupus erythematosus (SLE) patients as well as healthy donors. The proportion of Th cell subsets classified from cell surface markers (CD45RO, CXCR5, CXCR3, CCR6, PD-1, ICOS, and CCR7) is detected by flow cytometry.Results: We found no difference in the frequency of CD45RO+CXCR5+CD4+ T cells between SLE patients and health controls. As previously reported, SLE patients showed an increase in the percentage of CXCR5+PD-1+, CXCR5+ICOS+PD-1+ and CXCR5+CCR7loPD-1hi cTfh subset, however, none of these populations had correlation with SLEDAI. Therefore, we further investigated the CXCR5– subsets, and surprisingly we found that the frequency of CXCR3–PD-1+ subset was correlated with SLEDAI, ds-DNA IgG, anti-nucleosome antibody, C3, and C4 independent of CXCR5. Consistently, CXCR3–PD-1+CD45RO+CD4+T cells expressed factors associated with B-cell-help for the autoantibody production.Conclusion: CXCR3–PD-1+CD4+T cells are a sensitive indicator to assess SLE disease activity and might contribute B cell help and the generation of autoantibodies in patients.