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T helper cell dysfunction in systemic lupus erythematosus (SLE): Relation to disease activity

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Abstract

Patients with systemic lupus erythematosus (SLE) are known to have defects in both humoral and cellular immunity. The significance of defective T cell-mediated immunity and its relationship to disease activity have not been clearly established. We studiedin vitro T helper cell (Th) function in 150 SLE outpatients and correlated Th function with validated measures of disease activity. Interleukin 2 (IL-2) production by peripheral blood mononuclear cells (PBMC) was measured after stimulation with the recall antigens influenza A virus (FLU) and tetanus toxoid (TET), irradiated allogeneic peripheral blood mononuclear cells (ALLO), and phytohemagglutinin (PHA). We observed three patterns of Th response: (1) 76 of 150 (50%) of patients responded to the recall antigens FLU and/or TET, ALLO, and PHA; (2) 62 of 150 (42%) of patients did not respond to recall antigens but responded to ALLO and PHA; and (3) 12 of 150 (8%) of patients did not respond to either recall antigens or ALLO antigens. This diminished T cell function was correlated with higher disease activity as measured by four scales of clinical activity, such that individuals who exhibited morein vitro immune dysfunction presented with significant increases in their clinical activity indicies. The alterations in T cell function could not be accounted for by medication doses alone. Thus, SLE patients have multiple distinct defects at the level of the Th cell which are associated with clinical measures of disease activity.

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Authors and Affiliations

  1. Division of Molecular and Clinical Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, 21205, Baltimore, Maryland

    Michelle Petri & Daniel Goldman

  2. Division of Rheumatology and Clinical Immunology, University of Maryland School of Medicine, 21201, Baltimore, Maryland

    Charles S. Via

  3. Research Service, Baltimore VA Medical Center, 21201, Baltimore, Maryland

    Charles S. Via

  4. Experimental Immunology Branch, National Cancer Institute, National Institutes of Health, Building 10, Room 4B-17, 20892, Bethesda, Maryland

    Bonnie L. Bermas, Barbara Mittleman, Matthew W. Miller, Naomi I. Stocks & Gene M. Shearer

Authors
  1. Bonnie L. Bermas
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  2. Michelle Petri
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  3. Daniel Goldman
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  4. Barbara Mittleman
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  5. Matthew W. Miller
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  6. Naomi I. Stocks
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  7. Charles S. Via
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  8. Gene M. Shearer
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Bermas, B.L., Petri, M., Goldman, D. et al. T helper cell dysfunction in systemic lupus erythematosus (SLE): Relation to disease activity. J Clin Immunol 14, 169–177 (1994). https://doi.org/10.1007/BF01533366

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