Abstract
Abstract Objective: Reports on changes in the number and function of Tregs in Systemic Lupus Erythematosus (SLE) have been contradictory, possibly because most of those studies focused on identifying the whole Treg population, without dissecting the Treg subsets. This study aimed to enumerate the number and to study the role of various Treg subsets such as CD39+ Tregs , Naïve Tregs and activated Tregs in SLE patients. Results: Thirty SLE patients, 8 with active disease and 22 in remission, were recruited. The proportion of Tregs (CD4+CD25+Foxp3+) did not differ between patients with active lupus and those in remission (8.2±2.4% vs 7.5±3.8%, respectively; p=0.83). Similarly, there were no differences in these two groups of SLE patients in respect to the numbers of the naïve (CD4+CD45RA+Foxp3+) and activated Tregs (CD4+CD45RA-Foxp3high). However, the proportion of CD39+ Tregs was found to be significantly lower SLE patients with a flare, compared to those on remission (21.6±8.1% vs 41.9±4.7%, respectively; p=0.01). FACS-sorted CD39+ Tregs were found to be significantly more suppressive than CD39- Tregs. At the cut-off point 15.3%, CD39+ Tregs differentiated patients with active lupus from those in remission with the sensitivity of 95% and specificity of 75%. Conclusions: Fewer CD39+ Tregs in patients with active lupus indicates that CD39+ Tregs may play a crucial role in the pathogenesis of SLE. Furthermore, peripheral blood CD39+ Treg may be a biomarker for flares in SLE patients.
Published Version
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