Zeineb Zian

Morocco

Th1/Th17 Imbalance in Systemic Lupus Erythematosus and Lupus Nephritis

Zeineb Zian1,2*, Raouia Fakhfakh1*, Nesrine Elloumi1, Olfa Abida1, Emna Bouallegui1, Hana Houssaini1, Elisabetta Volpe3, Alessia Capone3, Hend Hachicha1, Sameh Marzouk4, Zouhir Bahloul4, Hatem Masmoudi1

1 Autoimmunity, Cancer, and Immunogenetics Research Laboratory, LR18SP12, University Hospital Habib Bourguiba of Sfax, 3029 Sfax, Tunisia
2 Intelligent Automation & BioMed Genomics Laboratory, Faculty of Sciences and Techniques of Tangier, University Abdelmalek Essaâdi, Tetouan, Morocco
3 Molecular Neuroimmunology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
4 Internal Medicine Department, Hedi Chaker University Hospital, Sfax, Tunisia

Abstract

Background

Systemic lupus erythematosus (SLE) is a complex autoimmune disease affecting almost all organs and tissues. SLE is characterized by a female predominance and T cell imbalance. Increased numbers of Th17 cells have been observed in SLE, especially in lupus nephritis (LN).
We studied the functional association of subpopulations of Th cells and SLE with (LN) or without (lupus erythematosus, LE) renal involvement by detecting intracellular cytokines and surface marker expression in peripheral blood mononuclear cells (PBMCs) of Tunisian patients.

Methods

Flow cytometry was used to analyze intracellular cytokine (IFN-?, IL-4, and IL-17A) production and surface marker (CCR6 and CXCR3) expression of PBMCs from 9 SLE patients fulfilling the American College of Rheumatology (ACR) 1997 and SLICC 2012 classification criteria and 5 healthy controls (HC). The IL23R and RORC mRNA expression levels were assessed using q-RT-PCR.

Results

Patients with LE and LN showed an increased level of Th17 and Th1 cells (p = 0.007 and p = 0.018, respectively) compared to HC. Only patients with LN exhibited increased levels of Th1/17 cells (p = 0.011) compared to HC. No significant difference was described in the mRNA expression levels of RORC and IL-23R between SLE and HC. Our findings showed that the frequencies of Th1 and Th17 cells were increased in patients with LE and LN compared to HC.

Conclusions

Our data suggested that the Th1/Th17 differentiation mechanisms are altered in SLE and this imbalance might be responsible for increased pro-inflammatory response and could have an important influence on the development and severity of the disease.