Immunophenotypes of Systemic Lupus Erythematosus-Features of Clinical and Laboratory Disorders.

OBJECTIVE

to evaluate subpopulations of B lymphocytes and features of interferon (IFN) status in patients with systemic lupus erythematosus (SLE), to clarify the relationship of immunological parameters with clinical manifestations of the disease.

MATERIALS AND

METHODS

: A total of 139 patients (123 women (88%) and 16 men (12%)) with a definite diagnosis of SLE were included in the analysis. The disease duration was 3.0 [0.3; 12.0] years, SLEDAI-2K 7 [4; 11] points, SDI 0 [0; 1] points. Immunophenotyping of peripheral blood lymphocytes, including determination of B cells, the general population of memory B cells, non-switched and switched memory B cells, naive, transient B cells, and plasmablasts was carried out using multicolor flow cytometry. IFN status was assessed by the expression of IFN-stimulated genes (MX1, RSAD2, and EPSTI1) using real-time polymerase chain reaction.

RESULTS

. Two immunological "patterns" were identified-the prevailing immunological mechanism of the pathogenesis of the disease (SLE) with predominant activation of type I IFN and with predominant activation of the B-cell component of the immune system. The immunological phenotype with activation of type I IFN was associated with high immunological activity, predominant skin damage, and leukopenia, whereas the phenotype with predominant activation of the B-cell component was associated with damage to the kidneys and nervous system.

CONCLUSIONS

. The results of the work suggest a wide variety of immune mechanisms underlying the pathogenesis of SLE. It is possible to identify a number of leading molecular "patterns" of the pathogenesis of the disease, which must be taken into account to select an effective "targeted" drug.