Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Dendritic Cells and Regulatory T CD4CD25Bright in Pregnant Patients with Systemic Lupus Erythematosus.

Jara1,  Luis J., Romero-Sanchez1,  Griselda Teresa, Montiel-Cervantes1,  Laura A., Medina1,  Gabriela, Cruz-Cruz2,  Polita, Vela-Ojeda1,  Jorge, Arias-Flores1,  Rafael

Hospital de Especialidades Centro Medico La Raza, IMSS, Mexico City, DF, Mexico
Hospital de Gineco-Obstetricia No.3, Centro Medico La Raza, IMSS, Mexico City, DF, Mexico

Introduction:

During pregnancy, dendritic cells (DC) participate in the shift from T-helper 1 (Th1) to T-helper 2 (Th2) activity. Myeloid DC induce Th1 cell differentiation, and plasmacytoid DC induce Th2 cell differentiation. On the other hand, CD4+ CD25bright+ FOXP3+ T regulatory cells (Treg cells) are CD4+ T cells with suppressive properties. An inadequate expression of Treg cells is associated with obstetric complications. Therefore, Treg/DC maintain maternal-fetal tolerance. However, their role in systemic lupus erythematosus (SLE) and pregnancy remains unknown.

Objective:

To analyze the changes of DC and Treg cells in the peripheral blood of pregnant SLE patients in comparison with normal pregnancy. To correlate these alterations with clinical activity and maternal-fetal complications of SLE patients.

Material and Methods:

Fifty pregnant, 25 with SLE (mean age 26.6+-6 years), and 25 pregnant healthy as controls (mean age 27.8+-5 years) were enrolled in the study. The majority of SLE patients were treated with low doses of prednisone (96%) and chloroquine (68 %). Mononuclear cells of peripheral blood were obtained during pregnancy (each trimester) and postpartum. The subtypes of DC and Treg cells from whole blood samples were analyzed as previously described. A total of 100 microlitres of whole blood was incubated with 20 microlitres of monoclonal specific antibodies: For DC Lin1-FITC, CD123-PE, HLADR-PERCP, CD11C-APC for determination of CD1(Myeloid DC), and CD2 (plasmacytoid DC). For Treg: FoxP3, CD4 PerPC, CD25 APC. The antibodies and cells were incubated for 25 min at room temperature in a dark room. Labeled cells were analyzed with the program Cell Quest pro, using FACSCalibur BD flow cytometer. We used SLAM-M modified to measured SLE activity during pregnancy. Statistic analysis: Mann-Whitney U test, Spearman correlation, and logistic regression.

Results:

Fetal loss (2), pre-eclampsia (2), and abortion (2) were observed in SLE patients. No maternal-fetal complications were observed in controls. During pregnancy, decrease tendencies of percentages of CD1, and Treg were observed in SLE patients vs controls: CD1, 35.2+-42 vs 58.3+-44 (p<0.06), and Treg, 53.9+-56 vs 89.8+-133 (p<0.2), with a significant decrease of CD2, 9.9+-8 vs 26.6+-25 (p< 0.003), respectively. In postpartum, a significant decrease of CD1 was observed in SLE patients: pregnancy SLE, 40.2+-35 vs postpartum SLE, 17.7+-17 (p< 0.05) without significant differences in CD2 and Treg. A direct correlation between CD1 and CD2 (r=0.58, p< 0.001), CD1 and Treg (r=0.65, p< 0.0001), and CD2 and Treg (r= 0.27, p<0.05) was found in SLE patients. In normal controls we did not observed a correlation among subpopulations of CD, and Treg. We did not observe a direct correlation among CD1, CD2, and Treg with SLAM-M in SLE patients.

Conclusions:

The significant decrease of CD2 during pregnancy, and CD1 in postpartum of SLE patients, with positive correlation among CD1, CD2, and Treg without correlations with SLE activity may reflect the immunological and subclinical activity of SLE. These alterations may be associated with maternal-fetal complications observed in these patients despite of treatment.

To cite this abstract, please use the following information:
Jara, Luis J., Romero-Sanchez, Griselda Teresa, Montiel-Cervantes, Laura A., Medina, Gabriela, Cruz-Cruz, Polita, Vela-Ojeda, Jorge, et al; Dendritic Cells and Regulatory T CD4CD25Bright in Pregnant Patients with Systemic Lupus Erythematosus. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1150
DOI: 10.1002/art.28916

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