Vincristine-Cyclophosphamide Combination Therapy Positively Affects T-Cell Subset Distribution in Systemic Lupus Erythematosus Patients
Junwei Chen, Lijuan Ding, Wu Meng, Jinhua Yang, Chenglan Yan, Jianfang Xie, Luo Jing, Xiaofeng Li, Zili Fu
Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China (mainland)
Med Sci Monit 2015; 21:505-510
This study aimed to analyze the T-cell subset distribution in systemic lupus erythematosus (SLE) patients and determine whether vincristine-cyclophosphamide combination therapy can positively affect their T-cell subset distribution to keep the disease in remission.
Material and Methods: Thirteen SLE patients with ‘low activity’ (SLE Disease Activity Index (SLEDAI)≤9), 17 SLE patients with ‘high activity’ (SLEDAI>9), and 15 healthy controls were recruited. SLE patients were treated with vincristine-cyclophosphamide combination therapy. CD3+, CD4+, and CD8+ T-cell percentages were analyzed by flow cytometry at baseline, 3 months, 6 months, 12–24 months, and >24 months.
Results: Significantly negative correlations were observed between the CD3+ and CD4+ T-cell percentages and SLEDAI scores at baseline (r=–0.471, P=0.015; r=–0.473, P=0.015, respectively). A significantly positive correlation was observed between CD4+ T-cell percentage and the complement component C3 at baseline (r=0.612, P=0.002). After 3 months of combination therapy, the CD3+ and CD4+ T-cell percentages were significantly higher than the high activity baseline (P<0.01, P<0.05, respectively). After 6 months, the CD3+, CD4+, and CD8+ T-cell percentages were all significantly higher than the high activity baseline (P<0.01, P<0.05, P<0.05, respectively).
Conclusions: T-cell subset distributions vary across different levels of SLE disease activity with higher CD3+ T-cell and CD4+ Th cell percentages favoring lower SLE activity. As CD3+ T-cell and CD4+ Th cell percentages negatively correlate with SLEDAI, vincristine-cyclophosphamide combination therapy appears to positively affect the T-cell subset distribution in SLE patients to keep the disease in remission by increasing their CD3+ T-cell and CD4+ Th cell percentages.
Keywords: Cyclophosphamide - therapeutic use, Drug Therapy, Combination, Lupus Erythematosus, Systemic - immunology, T-Lymphocyte Subsets - drug effects, Time Factors, Vincristine - therapeutic use