Abstract

Background Helper T cells 17 (Th17) and regulatory T cells (Treg)are two important immunoregulatory cells that act in opposite directions1. Previous study2 has shown that Th17/Treg cell balance is one of the important pathogenesis of systemic lupus erythematosus(SLE). Further researches3-5 believed that rapamycin(RAPA) alone or in combination with all-trans retinoic acid(ATRA) can regulate Th17/Treg cell balance, and then alleviate the condition of SLE. Objectives To investigate effect of the use of RAPA alone or combined ATRA on Th17/Treg cell balance in patients with SLE. Methods Seventy patients with SLE (64 females and 6 males, mean age 31.91±10.12 years, mean duration 61.14±53.64 months) in our hospital from March 2016 to June 2018 were enrolled. All of them were in line with the standard of ACR in 1997. The patients were randomly divided into RAPA group(RAPA0.5 mg/time, twice a week) and RAPA+ATRA group(RAPA and ATRA 10 mg/time, twice a week), 35 cases in each group. All were treated continuously for 24 weeks. The number of Th17 and Treg cells in peripheral blood before treatment and 6,12,24 weeks after treatment were measured. The SLEDAI scores and glucocorticoid dosage before and after the treatment were also observed to evaluate the differences of efficacy between the two groups. Results At different time in each group,the number of peripheral blood Th17 cells in SLE patients was decreased(P 0.05),the ratio of Th17/Treg cells induced(P 0.05). Compared with pretreatment, the number of Th17 cells, the ratio of Th17/Treg cells and SLEDAI scores after24 weeks treatment in SLE patients was decreased in RAPA group(P Conclusion Using RAPA or combined with ATRA could improve the condition of SLE patients by regulating Th17/Treg cells balance and reduce glucocorticoid dosage, which provided new directions for the pathogenesis and treatment of SLE.

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