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Vitamin A improve Th17 and Treg regulation in systemic lupus erythematosus

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Abstract

The aim of this study was to determine the role of vitamin A in modulating T helper 17 (Th17) and regulatory T cell (Treg) balance in systemic lupus erythematosus (SLE) patients. Sixty-two female SLE patients and sixty-two female controls were measured for vitamin A levels from serum by enzyme-linked immunosorbent assay (ELISA) and percentages of Th17 and Treg from peripheral blood mononuclear cells (PBMC) by flow cytometry. We also performed an in vitro study to evaluate the effects of retinoic acid treatment (0, 0.1, 0.2, and 0.3 μg/ml) in modulating Th17/Treg balance in CD4+ T cell culture from hypovitaminosis A SLE patients. Th17 and Treg percentages from cell cultures were measured by flow cytometry. Vitamin A levels in the SLE patients were lower compared to those in the healthy control (46.9 ± 43.4 vs. 75.6 ± 73.1 ng/ml, p = 0.015). Vitamin A levels also had a negative correlation to Th17 percentages in the SLE patients (p = 0.000, R = −0.642). Th17 percentages in the hypovitaminosis A SLE patients were higher compared to those SLE patients with normal vitamin A levels (10.9 ± 5.3 vs. 2.9 ± 2.2 %, p = 0.000). Treatment of 0.3 μg/ml of retinoic acid could increase Treg differentiation (33.9 ± 1.6 vs. 21.8 ± 1.1 %, p = 0.000) and decrease Th17 differentiation (27.2 ± 2.5 vs. 37.4 ± 1.3 %, p = 0.000). In conclusion, vitamin A has important roles in modulating Th17/Treg balance in the SLE patients shown by the significant decrease of vitamin A levels in the SLE patients which negatively correlate with Th17 population, and treatment of retinoic acid could decrease Th17 and increase Treg percentages in CD4+ T cells cultures.

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Acknowledgments

We thank Wahyudha, S.Si and Bunga Prihardina, S.Si. at Laboratory of Biomedic Brawijaya University for guiding us on culturing and flowcytometry analysis at the laboratory. This study was supported by the Brawijaya University and Directorate General of Higher Education (DGHE), Ministry of Research, Indonesia.

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Authors and Affiliations

  1. Department of Clinical Pathology, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia

    Kusworini Handono

  2. Faculty of Medicine Brawijaya University, Jalan Veteran, Malang, East Java, 65111, Indonesia

    Kusworini Handono

  3. Division of Rheumatology and Immunology, Department of Internal Medicine, Saiful Anwar General Hospital, Faculty of Medicine Brawijaya University, Malang, Indonesia

    Sevita Nuril Firdausi, Mirza Zaka Pratama & Handono Kalim

  4. Department of Parasitology, Faculty of Medicine Brawijaya University, Malang, Indonesia

    Agustina Tri Endharti

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  1. Kusworini Handono
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  2. Sevita Nuril Firdausi
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  3. Mirza Zaka Pratama
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  4. Agustina Tri Endharti
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  5. Handono Kalim
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Correspondence to Kusworini Handono.

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This study was approved by ethical committee of Brawijaya University for human research, and informed consent was obtained from each subject of the study.

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Handono, K., Firdausi, S.N., Pratama, M.Z. et al. Vitamin A improve Th17 and Treg regulation in systemic lupus erythematosus. Clin Rheumatol 35, 631–638 (2016). https://doi.org/10.1007/s10067-016-3197-x

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  • DOI: https://doi.org/10.1007/s10067-016-3197-x

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