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Immune profile alterations of systemic lupus erythematosus patients with infections

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Abstract

This study aimed to elucidate the immune status of systemic lupus erythematosus (SLE) patients with infections. We enrolled 253 SLE patients including 77 patients with infections. Clinical features and immunological parameters were analyzed, with particular reference to neutrophil CD64 (nCD64) expression, myeloid-derived suppressor cells (MDSCs), activated T cells and multiple cytokines. Among the 77 SLE patients with infections, 32 patients (41.56%) developed fever and 20 patients (25.97%) developed serositis, which were higher compared to the non-infection group. A considerably higher level of nCD64 was found in the infection group (4.65 vs 1.01, P < 0.001). In addition, the infection group exhibited higher percentages of total MDSCs (6.99 vs 4.30%, P = 0.003), polymorphonuclear MDSCs (PMN-MDSCs) (P = 0.032) and monocytic MDSCs (M-MDSCs) (P = 0.015). T cells were more activated during infections, with an elevated level of IL-2R (P < 0.001). Specifically, higher percentages of CD4+CD38+ T cells (55.73 vs 50.17%, P = 0.036), CD8+HLA-DR+ T cells (59.82 vs 47.99%, P < 0.001) and CD8+CD38+ T cells (68.59 vs 63.90%, P = 0.044) were identified in the infection group. Furthermore, the serum levels of IL-6, IL-8 and IL-10 were elevated in the infection group (all P < 0.001). Higher proportions of neutrophils, CD4+ and CD8+ T cells, and MDSCs were activated during infections in SLE patients. Additionally, the serum cytokines altered during infections, with noticeably elevated levels of IL-6, IL-8 and IL-10. Infections may lead to the amplification of immune alterations in SLE.

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Data availability

The data used during the study are available on reasonable request.

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Acknowledgements

We are very grateful to Dr Shi Bisheng and Dr Ma Xiaowei from Department of Laboratory Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University for flow cytometry analysis. We thank the patients and their families for their cooperation.

Funding

This work was supported by the National Natural Science Foundation of China (82001707 and 81373209), Shanghai Sailing Program (22YF1424000 and 20YF1425700), and the Fundamental Research Funds for the Central Universities (YG2023ZD09).

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Author notes

  1. Langxian Zhi and Liyang Gu are share first authorship.

  2. Liangjing Lu and Ruru Guo have contributed equally to this work and share senior authorship.

Authors and Affiliations

  1. Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, China

    Langxian Zhi, Liyang Gu, Xuesong Liu, Liangjing Lu & Ruru Guo

  2. State Key Laboratory of Oncogenes and Related Genes, Institute for Personalized Medicine, School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200030, China

    Lei Tong

  3. Department of Ultrasound, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China

    Xuesong Liu

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  1. Langxian Zhi
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Contributions

All authors contributed to the study conception and design. RG and LL designed the study and revised the manuscript. LZ and LG drafted the manuscript. LT and XL collected and analysed clinical data. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Liangjing Lu or Ruru Guo.

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The authors declare that they have no conflict of interest.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Written informed consent for publication of the study was obtained from all individual participants included in the study. All authors approved the final manuscript.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Renji Hospital (Number: [2017]201), Shanghai, China.

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Zhi, L., Gu, L., Tong, L. et al. Immune profile alterations of systemic lupus erythematosus patients with infections. Clin Exp Med 23, 4765–4777 (2023). https://doi.org/10.1007/s10238-023-01220-z

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