Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance
Objective The efficacy of sirolimus in treating severe or refractory systemic lupus erythematosus (SLE) has been confirmed by small-scale clinical trials. However, few studies focused on mild or moderate SLE. Therefore, in this study we elucidated clinical efficacy of add-on sirolimus in patients wi...
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| Language: | English |
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BMJ Publishing Group
2024-05-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/11/1/e001072.full |
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| author | Min Shi Lin Yang Jun Ma Xiaoping Wang Lu Jin Meng Ding Shaoxin Cui Fei Chang Hongtao Jin Aijing Liu Jinwen Zhao Jingjing He Shuran Song |
| author_facet | Min Shi Lin Yang Jun Ma Xiaoping Wang Lu Jin Meng Ding Shaoxin Cui Fei Chang Hongtao Jin Aijing Liu Jinwen Zhao Jingjing He Shuran Song |
| author_sort | Min Shi |
| collection | DOAJ |
| description | Objective The efficacy of sirolimus in treating severe or refractory systemic lupus erythematosus (SLE) has been confirmed by small-scale clinical trials. However, few studies focused on mild or moderate SLE. Therefore, in this study we elucidated clinical efficacy of add-on sirolimus in patients with mild or moderate SLE.Methods Data of 17 consecutive patients with SLE were retrospectively collected. SLE Disease Activity Index-2000 (SLEDAI-2K), clinical manifestation, laboratory data and peripheral T lymphocyte subsets with cytokines were collected before and 6 months after sirolimus add-on treatment. T cell subsets were detected by flow cytometry and cytokines were determined by multiplex bead-based flow fluorescent immunoassay simultaneously. Twenty healthy controls matched with age and sex were also included in our study.Results (1) The numbers of peripheral blood lymphocytes, T cells, T helper (Th) cells, regulatory T (Treg) cells, Th1 cells, Th2 cells and Treg/Th17 ratios in patients with SLE were significantly lower, while the numbers of Th17 cells were evidently higher than those of healthy control (p<0.05). (2) After 6 months of sirolimus add-on treatment, urinary protein, pancytopenia, immunological indicators and SLEDAI-2K in patients with SLE were distinctively improved compared with those before sirolimus treatment (p<0.05). (3) The numbers of peripheral blood lymphocytes, T cells, Th cells, Treg cells, Th2 cells and the ratios of Treg/Th17 in patients with SLE after treatment were clearly higher than those before (p<0.05). (4) The levels of plasma interleukin (IL)-5, IL-6 and IL-10 in patients with SLE decreased notably, conversely the IL-4 levels increased remarkably compared with pretreatment (p<0.05).Conclusions (1) Patients with SLE presented imbalanced T cell subsets, especially the decreased ratio of Treg/Th17. (2) Sirolimus add-on treatment ameliorated clinical involvement, serological abnormalities and disease activity without adverse reactions in patients with SLE. (3) The multi-target therapy facilitates the enhanced numbers of Treg cells, Treg/Th17 imbalance and anti-inflammatory cytokines, simultaneously, reducing inflammatory cytokines. |
| format | Article |
| id | doaj-art-a295d815dbf54764aa7c630dd646e487 |
| institution | Kabale University |
| issn | 2053-8790 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-a295d815dbf54764aa7c630dd646e4872024-11-10T08:15:09ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-05-0111110.1136/lupus-2023-001072Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balanceMin Shi0Lin Yang1Jun Ma2Xiaoping Wang3Lu Jin4Meng Ding5Shaoxin Cui6Fei Chang7Hongtao Jin8Aijing Liu9Jinwen Zhao10Jingjing He11Shuran Song12Hebei Key Laboratory of Laboratory Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Anatomy, Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Rheumatology and Immunology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Clinical Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaObjective The efficacy of sirolimus in treating severe or refractory systemic lupus erythematosus (SLE) has been confirmed by small-scale clinical trials. However, few studies focused on mild or moderate SLE. Therefore, in this study we elucidated clinical efficacy of add-on sirolimus in patients with mild or moderate SLE.Methods Data of 17 consecutive patients with SLE were retrospectively collected. SLE Disease Activity Index-2000 (SLEDAI-2K), clinical manifestation, laboratory data and peripheral T lymphocyte subsets with cytokines were collected before and 6 months after sirolimus add-on treatment. T cell subsets were detected by flow cytometry and cytokines were determined by multiplex bead-based flow fluorescent immunoassay simultaneously. Twenty healthy controls matched with age and sex were also included in our study.Results (1) The numbers of peripheral blood lymphocytes, T cells, T helper (Th) cells, regulatory T (Treg) cells, Th1 cells, Th2 cells and Treg/Th17 ratios in patients with SLE were significantly lower, while the numbers of Th17 cells were evidently higher than those of healthy control (p<0.05). (2) After 6 months of sirolimus add-on treatment, urinary protein, pancytopenia, immunological indicators and SLEDAI-2K in patients with SLE were distinctively improved compared with those before sirolimus treatment (p<0.05). (3) The numbers of peripheral blood lymphocytes, T cells, Th cells, Treg cells, Th2 cells and the ratios of Treg/Th17 in patients with SLE after treatment were clearly higher than those before (p<0.05). (4) The levels of plasma interleukin (IL)-5, IL-6 and IL-10 in patients with SLE decreased notably, conversely the IL-4 levels increased remarkably compared with pretreatment (p<0.05).Conclusions (1) Patients with SLE presented imbalanced T cell subsets, especially the decreased ratio of Treg/Th17. (2) Sirolimus add-on treatment ameliorated clinical involvement, serological abnormalities and disease activity without adverse reactions in patients with SLE. (3) The multi-target therapy facilitates the enhanced numbers of Treg cells, Treg/Th17 imbalance and anti-inflammatory cytokines, simultaneously, reducing inflammatory cytokines.https://lupus.bmj.com/content/11/1/e001072.full |
| spellingShingle | Min Shi Lin Yang Jun Ma Xiaoping Wang Lu Jin Meng Ding Shaoxin Cui Fei Chang Hongtao Jin Aijing Liu Jinwen Zhao Jingjing He Shuran Song Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance Lupus Science and Medicine |
| title | Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance |
| title_full | Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance |
| title_fullStr | Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance |
| title_full_unstemmed | Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance |
| title_short | Add-on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via T lymphocyte subsets balance |
| title_sort | add on sirolimus for the treatment of mild or moderate systemic lupus erythematosus via t lymphocyte subsets balance |
| url | https://lupus.bmj.com/content/11/1/e001072.full |
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