AB0492 The Influence of Therapy on CD4+Cd25highfoxp3+ T Regulatory Cells in Systemic Lupus Erythematosus Patients: A Prospective Study. (10th June 2014)

• Record Type: Journal Article
• Authors: Tselios, K.; Sarantopoulos, A.; Gkougkourelas, I.; Georgiadou, A.-M.; Klonizakis, P.; Kalogeridis, A.; Vlachaki, E.; Boura, P.
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Supplement 2(2014)
• Page Start: 969
• Page End: 970
• Publication Date: 2014-06-10
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-eular.3810
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: T regulatory cells (Tregs) are inversely correlated to disease activity in systemic lupus erythematosus (SLE). However, little is known concerning the influence of immunosuppressive agents on Tregs and their kinetics, which was the objective of this study. Methods: Thirty five lupus patients (29 females, 6 males, mean age 42.4±12.8 years, mean disease duration 97.5±16.2 months), in whom a dose increase of current drugs or administration of a new drug was required, were included. Tregs (CD4+CD25 high FOXP3+) were prospectively assessed by flow cytometry every month for intravenous (iv) and quarterly for oral regimens. Clinical assessment was made with SLE Disease Activity Index (SLEDAI). Statistical analysis was performed with Student's t-test or Mann-Whitney U test; p <0.05 was considered significant. Results: In total, 44 cases of SLE relapse were treated with iv cyclophosphamide (n=10), iv methylprednisolone (n=7), iv immunoglobulins (IVIGs, n=5), oral methylprednisolone (n=8), oral methylprednisolone and azathioprine (n=8) and hydroxychloroquine (n=6). Cyclophosphamide, iv methylprednisolone and IVIGs resulted in a significant increase of Tregs (4.2±1.6 to 10.1±5.7 cells/mm 3, 2.9±1.3 to 10.6±4.8 cells/mm 3 and 5.6±2.7 to 15.2±6.3 cells/mm 3 respectively, p <0.05). Oral methylprednisolone, alone or combined to azathioprine, led to significant Tregs increment (7.4±2.5 to 11.8±3.8 cells/mm 3 and 5.1±2.4 to 9.4±3.6 cells/mm 3 respectively, p <0.05). Likewise, hydroxychloroquine resulted in significant Tregs increase (8.2±2.4 to 12.8±2.7 cells/mm 3, p <0.05). Time to Tregs recovery was significantly shorter with iv methylprednisolone and IVIGs, compared to cyclophosphamide (1.4±0.5, 1.6±0.9 and 4±1.5 months respectively, p <0.05). Conclusions: Tregs increment during SLE remission is independent of the therapeutic regimen used and probably represents an epiphenomenon. Time to Tregs restoration was significantly shorter in patients treated with iv methylprednisolone and IVIGs, compared to cyclophosphamide pulse therapy. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2014-eular.3810