Natural Killer and Natural Killer T Cells in Juvenile Systemic Lupus Erythematosus: Relation to Disease Activity and Progression

  • Asmaa M. Zahran
  • Mona H. Abdel-Rahim
  • Khalid I. Elsayh
  • Manal M. Hassanien
  • Safaa A. Mahran
  • Helal F. HettaEmail author
Original Article


The contribution of innate immune cells, including natural killer (NK) and natural killer T (NKT) cells, in systemic lupus erythematosus (SLE) is still unclear. Herein, we examined the frequency of peripheral NK cells, CD56dim and CD56bright NK cells, and NKT cells in patients with juvenile SLE and their potential relations to SLE-related clinical and laboratory parameters. The study included 35 SLE children and 20 apparently healthy controls. After baseline clinical and lab work, SLE Disease Activity Index (SLEDAI-2K) and Pediatric Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index (Ped-SDI) scores were assessed. The frequency of peripheral NK cells, CD56dim and CD56bright NK cells, and NKT cells was examined using flow cytometry. SLE patients showed significantly lower frequency of NK cells and NKT cells and higher frequency of CD56bright NK cells compared to controls. Disease activity, urea, and creatinine correlated negatively with NK, but positively with CD56bright NK cells. NK and NKT cells exhibited inverse correlation with the renal biopsy activity index; however, CD56bright NK cells showed direct correlations with both activity and chronicity indices. Regarding Ped-SDI, renal, neuropsychiatry disorders, and growth failure correlated inversely with NK but directly with CD56bright NK cells. NKT cell inversely correlated with renal damage and delayed puberty. In conclusion, low frequency of NK and NKT and expansion of CD56bright NK cells are marked in juvenile SLE, particularly with activity. These changes have direct effect on renal impairment and growth failure, reflecting their potential influence on disease progression.


NK cells NKT cells SLE 



Antinuclear antibodies


Antidouble-stranded DNA


C-reactive protein


Erythrocyte sedimentation rate


Natural killer


Natural killer T


Pediatric Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index


Standard deviation


Systemic lupus erythematosus


Systemic Lupus Erythematosus Disease Activity Index


Gamma delta T cells



The authors appreciate the all participants in this study, especially the patients.

Compliance with ethical standards

Conflict of interest



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Copyright information

© L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland 2019

Authors and Affiliations

  1. 1.Clinical Pathology Department, South Egypt Cancer InstituteAssiut UniversityAssiutEgypt
  2. 2.Department of Medical Microbiology and Immunology, Faculty of MedicineAssiut UniversityAssiutEgypt
  3. 3.Pediatric Department, Faculty of MedicineAssiut UniversityAssiutEgypt
  4. 4.Rheumatology and Rehabilitation Department, Faculty of MedicineAssiut UniversityAssiutEgypt
  5. 5.Department of Internal MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA

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