Peripheral CD4+ cell prevalence and pleuropulmonary manifestations in systemic lupus erythematosus patients

Respir Med. 2014 May;108(5):766-74. doi: 10.1016/j.rmed.2014.02.006. Epub 2014 Feb 18.


Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving several organs, including the lungs. Previous results confirmed changes of peripheral T cell subsets in lupus patients; however no data are available about their possible relationship with pulmonary involvement.

Objective: To determine pulmonary manifestations and potential relationship in changes of peripheral CD4+ T cell subsets.

Methods: Patients with SLE (N = 28) were enrolled in complex pulmonary examination. Patients were divided into groups with pleuropulmonary manifestations (SLEpulm N = 13 age: 44.9 ± 3.3 years, female: male = 11:2) or without (SLEc N = 15 age: 27.2 ± 3.7 years, female: male = 12:3). Peripheral blood was taken for T helper (Th)1, Th2, Th17, CD4+CD25hi+ and regulatory T (Treg: CD4+CD25hi+ CD127-) cell analysis from SLE patients and healthy volunteers (controls, N = 40).

Results: SLEpulm patients were older, had more pulmonary symptoms and significantly decreased pO2 as compared to SLEc group. Ventilatory disorder was present in 92% of SLEpulm patients, with significantly decreased lung volumes, signs of airway involvement and decrease in DLco. Significant increase in Th1/Th2, while decrease in Th17/Treg ratios was present in all SLE compared to controls. In SLEpulm CD4+CD25hi+ subset without changes in Treg number was significantly increased as compared to SLEc and this subgroup of T cell showed significant positive correlation with dynamic lung function parameters and DLco (p < 0.05).

Conclusion: In lupus patients pleuropulmonary manifestations are prevalent and lung function and blood gas measurements should be regularly performed in the daily clinical assessment. Significant increase of activated CD4+CD25hi+ T cells, but not Treg is associated with decreased lung function parameters in SLEpulm patients.

Keywords: CD4+CD25hi+; Lung; Lung function; Systemic lupus erythematosus; T cells.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • CD4-Positive T-Lymphocytes / immunology*
  • Carbon Dioxide / blood
  • Child
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lung Diseases / etiology
  • Lung Diseases / immunology*
  • Lung Diseases / physiopathology
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / immunology*
  • Lupus Erythematosus, Systemic / physiopathology
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Oxygen / blood
  • Partial Pressure
  • Respiratory Mechanics / physiology
  • T-Lymphocyte Subsets / immunology
  • Young Adult


  • Immunosuppressive Agents
  • Carbon Dioxide
  • Oxygen