Belimumab restores Treg/Th17 balance in patients with refractory systemic lupus erythematosus

被引：23

作者：

Prete, M. ^{[1
]}

Leone, P. ^{[1
]}

Frassanito, M. A. ^{[1
]}

Desantis, V. ^{[1
]}

Marasco, C. ^{[1
]}

Cicco, S. ^{[1
]}

Dammacco, F. ^{[1
]}

Vacca, A. ^{[1
]}

Racanelli, V. ^{[1
]}

机构：

[1] Univ Bari, Med Sch, Unit Internal Med Guido Baccelli, Dept Biomed Sci & Human Oncol, 11 Piazza G Cesare Policlin, I-70124 Bari, Italy

来源：

LUPUS | 2018年 / 27卷 / 12期

关键词：

Belimumab; IL-17A-secreting cells; immunomodulation; regulatory T cells; systemic lupus erythematosus; REGULATORY T-CELLS; DISEASE-ACTIVITY; AUTOIMMUNE-DISEASES; MONOCLONAL-ANTIBODY; TH17; CELLS; DIFFERENTIATION; RAPAMYCIN; TARGET; CD4(+)CD25(HIGH); SUPPRESSION;

D O I：

10.1177/0961203318797425

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Belimumab, a specific inhibitor of the soluble B lymphocyte stimulator (BlyS), is the first biological drug approved by the United States Food and Drug Administration for the treatment of patients with active systemic lupus erythematosus (SLE) refractory to standard therapy. Given that an imbalance between regulatory T cells (Treg) and interleukin (IL)-17A-secreting T cells (Th17) has been reported in various autoimmune disorders, we assessed the frequency of both Treg and Th17 peripheral blood populations before and after belimumab administration in 20 patients with active SLE refractory to standard therapy. After six months of treatment, the mean SELENA-SLEDAI score as well as the mean anti-double-stranded DNA antibody titers were significantly decreased. In addition, we observed a significant increase in Treg percentages and a parallel, significant decrease in Th17 percentages, accompanied by significantly reduced serum levels of IL-21. In vitro studies showed that Treg purified from belimumab-treated patients were fully functional and displayed a suppressor function similar to that of Treg purified from healthy donors. Belimumab can restore Treg/Th17 balance in SLE patients with uncontrolled disease activity, and this results in decreased flare rate and reduced glucocorticoid dosage.

引用

页码：1926 / 1935

页数：10

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[1] Balance between Regulatory T and Th17 Cells in Systemic Lupus Erythematosus: The Old and the New [J].