- Original article
- Open Access
Serum vitamin D and peripheral T-regulatory cells in systemic lupus erythematosus and their relation with disease activity
Egyptian Rheumatology and Rehabilitation volume 41, pages 167–171 (2014)
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.
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.
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.
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.
Singh A, Kamen DL. Potential benefits of vitamin D for patients with systemic lupus erythematosus. Dermatoendocrinol 2012; 4:146–151.
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.
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.
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.
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.
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.
Petri M, Magder L. Classification criteria for systemic lupus erythematosus: a review. Lupus 2004; 13:829–837.
Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002; 29:288–291.
Claudia DL, Andréa TD, Thiago SF, et al. The importance of vitamin D levels in autoimmune diseases. Rev Bras Reumatol 2010; 10:1590.
Horwiz DA. Regulatory T cells in systemic lupus erythematosus:past, present and future. Arthritis Res Ther 2008; 10:227.
Mouyis M, Ostor AJK, Crisp AJ, et al. Hypovitaminosis D among rheumatology outpatients in clinical practice. Rheumatology 2008; 47:1348–1351.
Toubi E, Shoenfeld Y. The role of vitamin D in regulating immune responses. Isr Med Assoc J 2010; 12:174–175.
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.
Sakthiswary R, Raymond AA. The clinical significance of vitamin D in systemic lupus erythematosus: a systematic review. PLoS One 2013; 8:e55275.
Attar SM, Siddiqui AM. Vitamin D deficiency in patients with systemic lupus erythematosus. Oman Med J 2013; 28:42–47.
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.
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.
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.
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.
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.
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.
Alvarado SB, Hernandez CB, Portales PD. Regulatory T cells in patients with systemic lupus erythematosus. J Autoimmun 2006; 27:110–118.
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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
- systemic lupus erythematosus
- T-regulatory cells
- vitamin D