Abstract
Systemic lupus erythematosus (SLE) patients have a decreased number of T-regulatory cells (Tregs) in peripheral blood. Vitamin D deficiency is prevalent in SLE. Immunomodulatory effects of vitamin D include the expansion of Tregs. The aim of this study was to assess the percentage of Tregs and vitamin D level in SLE and their relation with disease activity. A total of 40 SLE patients underwent evaluation for disease activity using the SLE disease activity index and were tested for the percentage of peripheral Tregs using anti-CD4, anti-CD25, and anti-FOXP3 monoclonal antibodies. Vitamin D was assessed using a commercially available 25-OH VitD-EIA kit. The study also included 40 healthy individuals who served as controls. SLE patients had lower levels of vitamin D (22.3 ± 7.53) and Treg% (1.95 ± 0.18) in comparison with controls. Patients with active disease had significantly lower levels of vitamin D. However, there was no significant difference between patients with and those without disease activity as regards Tregs. Correlation between vitamin D and various disease parameters showed negative correlation between vitamin D and each of disease activity, creatinine, and urinary protein (P < 0.05) and a positive correlation with C4 (P < 0.05). Correlation between Tregs% and various disease parameters showed a significant negative correlation as regards anti-dsDNA (P < 0.05). No correlation was detected between Tregs% and vitamin D. There are decreased levels of vitamin D and Treg% in SLE. Lower levels of vitamin D correlate with disease activity; yet, no correlation between serum vitamin D and Treg% was detected.
Highlights
Systemic lupus erythematosus (SLE) is a complex multisystem autoimmune disease
The impact of vitamin D on immune function previously seen in vitro and in crosssectional studies has been shown in prospective human studies, strengthening the evidence that there is a connection between SLE and vitamin D status [1]
Patients in group I were further subdivided on the basis of disease activity into group Ia and group Ib
Summary
Systemic lupus erythematosus (SLE) is a complex multisystem autoimmune disease. Vitamin D deficiency has been proposed as an environmental trigger of disease onset and as a contributor to increased activity in SLE. SLE patients are prone to develop vitamin D deficiency because of photosensitivity, leading to sun avoidance and other sun protective measures. The impact of vitamin D on immune function previously seen in vitro and in crosssectional studies has been shown in prospective human studies, strengthening the evidence that there is a connection between SLE and vitamin D status [1]. Vitamin D in general exerts an inhibitory action on the adaptive immune response through several mechanisms, including the inhibition of dendritic cell maturation, Th1 activity, B cel maturation and differentiation, and function of T-regulatory cells [2]. Systemic lupus erythematosus (SLE) patients have a decreased number of T-regulatory cells (Tregs) in peripheral blood.
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