人循环T免疫指数及血小板参数对系统性红斑狼疮治疗效果的预测价值

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Abstract Objective To analyze the changes of CD4⁺CD28^nullT cells and platelet-bound complement cleavage products (PC4d) in patients with active and inactive systemic lupus erythematosus (SLE) and normal controls, and evaluate their significance as biomarkers for judging disease activity and therapeutic effect. Methods This was a single-center, observational cohort study in our hospital. The study time is from January 2021 to June 2022. The subjects were 90 SLE patients aged 15-70 and 22 healthy controls. Calculate systemic lupus erythematosus disease activity index (SLEDAI) to evaluate the overall disease activity; Patients with SLEDAI score>4 were regarded as active SLE, and the rest were classified as inactive SLE. The levels of CD4⁺CD28^nullT cells and PC4d were analyzed by flow cytometry. Results Compared with the healthy control group, the patients in active SLE group were younger, and the levels of CD4⁺CD28^nullT and PC4d were higher. The differences in WHO classification, SLEDAI, and CD4+CD28null T cells between patients with active SLE and those with inactive SLE were statistically significant. The levels of CD4⁺CD28^nullT and PC4d were positively correlated with SLEDAI (r=0.214, P<0.05; r=0.410, P<0.05). The difference in the percentage of CD4+CD28null T cells across different WHO classifications was statistically significant. and the percentage of CD4⁺CD28^nullT cells in WHO grade 5 was significantly higher than that in other grades. Compared with the group with treatment response, the levels of CD4⁺CD28^nullT and PC4d in the group without treatment response increased significantly. ROC curve showed that the AUC values of CD4⁺CD28^nullT and PC4d in predicting the treatment response of SLE in active stage were 0.759(95%CI: 0.604-0.914) and 0.923(95%CI: 0.832-1.000), respectively. Conclusion The expansion of CD4⁺CD28^nullT cell and the increase of PC4d level are closely related to the disease activity of SLE patients, and they can be used as potential candidate biomarkers to predict the treatment response of active SLE patients.

Key words： systemic lupus erythematosus active phase CD4⁺CD28^null T cells platelet-bound complement cleavage products treatment response

Received: 30 July 2024

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R593

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	WANG Jing
	YANG Xiaofei

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WANG Jing,YANG Xiaofei. Predictive value of human circulating T immune index and platelet parameters on the therapeutic effect of systemic lupus erythematosus[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(5): 128-133.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I5/128

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