Skip to main content

Serum vitamin D and peripheral T-regulatory cells in systemic lupus erythematosus and their relation with disease activity

Abstract

Background

Systemic lupus erythematosus (SLE) patients have a decreased number of T-regulatory cells (Tregs) in peripheral blood. Vitamin D deficiency is prevalent in SLE. Immunomodulatory effects of vitamin D include the expansion of Tregs.

Objectives

The aim of this study was to assess the percentage of Tregs and vitamin D level in SLE and their relation with disease activity.

Patients and Methods

A total of 40 SLE patients underwent evaluation for disease activity using the SLE disease activity index and were tested for the percentage of peripheral Tregs using anti-CD4, anti-CD25, and anti-FOXP3 monoclonal antibodies. Vitamin D was assessed using a commercially available 25-OH VitD-EIA kit. The study also included 40 healthy individuals who served as controls.

Results

SLE patients had lower levels of vitamin D (22.3 ± 7.53) and Treg% (1.95 ± 0.18) in comparison with controls. Patients with active disease had significantly lower levels of vitamin D. However, there was no significant difference between patients with and those without disease activity as regards Tregs. Correlation between vitamin D and various disease parameters showed negative correlation between vitamin D and each of disease activity, creatinine, and urinary protein (P < 0.05) and a positive correlation with C4 (P < 0.05). Correlation between Tregs% and various disease parameters showed a significant negative correlation as regards anti-dsDNA (P < 0.05). No correlation was detected between Tregs% and vitamin D.

Conclusion

There are decreased levels of vitamin D and Treg% in SLE. Lower levels of vitamin D correlate with disease activity; yet, no correlation between serum vitamin D and Treg% was detected.

References

  1. Singh A, Kamen DL. Potential benefits of vitamin D for patients with systemic lupus erythematosus. Dermatoendocrinol 2012; 4:146–151.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kusworini H, Dona M, Handono K. Association between the low levels of vitamin D and treg function in systemic lupus erythematosus patients. Acta Med Indones 2013; 45:26–31.

    Google Scholar 

  3. Lim HW, Hillsamer P, Kim CH. Regulatory T cells can migrate to follicles upon T cell activation and suppress GC-Th cells and GC-Th cell-driven B cell responses. J Clin Invest 2004; 114:1640–1649.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  4. Sakaguchi S. Naturally arising Foxp3-expressing CD25+CD4+ regulatory T cells in immunological tolerance to self and non-self. Nat Immunol 2005; 6:345–352.

    CAS  Article  PubMed  Google Scholar 

  5. Lee HY, Yun HJ, Kim YM, et al. Altered frequency and migration capacity of CD4+CD25+ regulatory T cells in systemic lupus erythematosus. Rheumatology (Oxford) 2008; 47:789–794.

    CAS  Article  Google Scholar 

  6. Terrier B, Derian N, Schoindre Y, et al. Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation. Arthritis Res Ther 2012; 14:R221.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Petri M, Magder L. Classification criteria for systemic lupus erythematosus: a review. Lupus 2004; 13:829–837.

    CAS  Article  PubMed  Google Scholar 

  8. Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002; 29:288–291.

    PubMed  Google Scholar 

  9. Claudia DL, Andréa TD, Thiago SF, et al. The importance of vitamin D levels in autoimmune diseases. Rev Bras Reumatol 2010; 10:1590.

    Google Scholar 

  10. Horwiz DA. Regulatory T cells in systemic lupus erythematosus:past, present and future. Arthritis Res Ther 2008; 10:227.

    Article  Google Scholar 

  11. Mouyis M, Ostor AJK, Crisp AJ, et al. Hypovitaminosis D among rheumatology outpatients in clinical practice. Rheumatology 2008; 47:1348–1351.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  12. Toubi E, Shoenfeld Y. The role of vitamin D in regulating immune responses. Isr Med Assoc J 2010; 12:174–175.

    PubMed  Google Scholar 

  13. Sumethkul K, Boonyaratavej S, Kitumnuaypong T, et al. The predictive factors of low serum 25-hydroxyvitamin D and vitamin D deficiency in patients with SLE. Rheumatol Int 2013; 33:1461–1467.

    CAS  Article  PubMed  Google Scholar 

  14. Sakthiswary R, Raymond AA. The clinical significance of vitamin D in systemic lupus erythematosus: a systematic review. PLoS One 2013; 8:e55275.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Attar SM, Siddiqui AM. Vitamin D deficiency in patients with systemic lupus erythematosus. Oman Med J 2013; 28:42–47.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ruiz IG, Egurbide MV, Olivares N, et al. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford) 2008; 47:920–923.

    Article  Google Scholar 

  17. Fragoso TS, Dantas AT, Marques CD, et al. 25-Hydroxyivitamin D3 levels in patients with systemic lupus erythematosus and its association with clinical parameters and laboratory tests. Rev Bras Reumatol 2012; 52:60–65.

    Article  PubMed  Google Scholar 

  18. Vila LM, Alarcon GS, McGwin G, et al. Systemic lupus erythematosus in a multiethnic US cohort, association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis Rheum 2006; 55:799–806.

    Article  PubMed  Google Scholar 

  19. Liu MF, Wang CR, Fung LL, Wu CR. Decreased CD4+CD25+ T cells in peripheral blood of patients with systemic lupus erythematosus. Scand J Immunol 2004; 59:198–202.

    Article  PubMed  Google Scholar 

  20. Yang XY, Lu XY, Xu DH, Lu QH, Wang QH, Wu HX. Clinical significance of CD4+CD25+ T cells in peripheral blood of patients in systemic lupus erythematosus. Zhonghua Nei Ke Za Zhi 2005; 44:570–572.

    CAS  PubMed  Google Scholar 

  21. Iikuni N, Lourenço EV, Hahn BH, La Cava A. Cutting edge: regulatory T cells directly suppress B cells in systemic lupus erythematosus. J Immunol 2009; 183:1518–1522.

    CAS  Article  PubMed  Google Scholar 

  22. Alvarado SB, Hernandez CB, Portales PD. Regulatory T cells in patients with systemic lupus erythematosus. J Autoimmun 2006; 27:110–118.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Reem A. Habeeb MD.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Habeeb, R.A., Elkabarity, R.H. Serum vitamin D and peripheral T-regulatory cells in systemic lupus erythematosus and their relation with disease activity. Egypt Rheumatol Rehabil 41, 167–171 (2014). https://doi.org/10.4103/1110-161X.147359

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-161X.147359

Keywords

  • systemic lupus erythematosus
  • T-regulatory cells
  • vitamin D