Role of T- regulatory cells and FOXP3 in lupus nephritis

Document Type : Original Article

Authors

1 Department of Internal Medicine, Faculty of medicine – Minia University

2 Department of Clinical Pathology, Faculty of medicine – Minia University

Abstract

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease characterized 
by a progressive breakdown of tolerance to self-antigens and the presence of concomitant 
hyperactive immune responses (Giang and La Cava, 2016). Aim of the work: The aim of this 
study is to assess the level of CD4, CD25 and FOXP3 T-regulatory cells in lupus nephritis 
patients in regard to disease activity. Subjects and Methods: The present study was 
conducted out on 100 subjects from the attendants of the outpatient clinics of internal 
medicine department, Minia university hospital, during the period from April 2016 to 
June 2017, 70 patients were diagnosed as lupus nephritis according to the presence of 
proteinuria (>500mg/24h) and/or hematuria and/or urinary casts, according to the recent 
recommendations from European League Against Rheumatism and 30 apparently healthy 
subjects as control matched for age and sex (Bertsias GK et al., 2012). Results: This study 
was carried out on 100 subjects classified into two groups: Group 1: Included 70 patients 
diagnosed as lupus nephritis 15 males and 55 females, their ages range from (22-40) years.
Group 2: Included 30 apparently healthy subjects, 7 males and 23 females their ages from 
(20-40) years. Discussion: Lupus nephritis (LN) is mainly used to define the immune 
complex-mediated glomerulonephritis (GN) and it is the most important complication of 
systemic lupus erythematosus (SLE), which is responsible for SLE related mortality and 
morbidity. LN occurs in up to 50% of patients with SLE. In LN, the deposition of immune 
complexes plays a leading role in the initiation of the disease (Shakweer et al., 2016).
Conclusion: Tregs % was found significantly lower in active lupus nephritis especially stage 
(III and IV) and correlates with all parameters of disease activity.
Limitations: Limitations to be considered in the present study including the small number of 
patients, which does not allow for definite conclusions, and the lack of functional assays for 
more precise Tregs characterization. Furthermore, it would be helpful to assess the urinary 
levels of Foxp3 mRNA, in parallel to serum levels, in order to clarify their importance in LN 
activity and response to treatment.

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