The proportion of regulatory T cells in patients with ankylosing spondylitis: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LAI Nalin , ZHANG Shengxiao , YAN Ming , CHENG Ting , MAO Xiaojuan ,  LI Xiaofeng

Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, P.R.China;

Corresponding?author：

LI Xiaofeng, Email: 13753139859@163.com

Keywords：

Ankylosing spondylitis; Tregs; Meta-analysis; Systematic review; Case-control study

DOI：

10.7507/1672-2531.201902084

Video：

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Objectives To systematically review the proportion of Tregs in peripheral blood of patients with ankylosing spondylitis (AS) and its relationship with Treg's diffrent phenotypes.Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect case-control studies on peripheral Tregs of AS patients from inception to November 31^st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.Results A total of 61 case-control studies involving 2 466 AS patients and 1 879 controls were included. The results of meta-analysis showed that: the proportion of peripheral Tregs of patients with AS was significantly lower than that of the normal control (SMD=?0.905, 95%CI ?1.294 to ?0.517, P<0.000 1), and the proportion of Tregs in the disease-active group was significantly lower than that in disease-inactive group (SMD=?0.928, 95%CI ?1.431 to ?0.425, P<0.000 1). The proportion of CD4⁺CD25⁺FOXP3⁺Tregs and CD4⁺CD25⁺CD127^low/?Tregs were lower in AS patients than that in control subjects (SMD=?2.547, 95%CI ?3.521 to ?1.573, P<0.000 1; SMD=?0.709, 95% CI ?1.056 to ?0.362, P<0.000 1). The proportion of Tregs defined by CD4⁺CD25^low/?FOXP3⁺ was higher in AS patients (SMD=0.683, 95%CI 0.161 to 1.206, P=0.01). There was no significant difference betweew other phenotypes of Tregs groups.roups.Conclusions The reduction of Tregs may be one of the important reasons for the occurrence and development of AS, which may provide a new approach for the diagnosis and treatment of AS.

Citation： LAI Nalin, ZHANG Shengxiao, YAN Ming, CHENG Ting, MAO Xiaojuan, LI Xiaofeng. The proportion of regulatory T cells in patients with ankylosing spondylitis: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(10): 1170-1180. doi: 10.7507/1672-2531.201902084 Copy

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1. Braun J, Sieper J. Ankylosing spondylitis. Lancet, 2007, 369(9570): 1379-1390.
2. Dejaco C, Duftner C, Grubeck-Loebenstein B, et al. Imbalance of regulatory T cells in human autoimmune diseases. Immunology, 2006, 117(3): 289-300.
3. Guo H, Zheng M, Zhang K, et al. Functional defects in CD4⁺ CD25^high FoxP3⁺ regulatory cells in ankylosing spondylitis. Sci Rep, 2016, 6: 37559.
4. Bonelli M, Smolen JS, Scheinecker C. Treg and lupus. Ann Rheum Dis, 2010, 69(Suppl 1): i65-i66.
5. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum, 1984, 27(4): 361-368.
6. Group OLoEW. The Oxford 20114 Levels of Evidence. Oxford: Centre for Evidence-Based Medicine, 2011.
7. Wells GA, Shea B, O'connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Oxford: 3rd Symposium on Systematic Reviews, 2000.
8. DerSimonian R, Kacker R. Random-effects model for meta-analysis of clinical trials: an update. Contemp Clin Trials, 2007, 28(2): 105-114.
9. Cao D, van Vollenhoven R, Klareskog L, et al. CD25 bright CD4⁺ regulatory T cells are enriched in inflamed joints of patients with chronic rheumatic disease. Arthritis Res Ther, 2004, 6(4): R335-R346.
10. 陳麗娜. CD4⁺CD25(high) Treg 在類風濕關節炎不同病期和 TNF-α 受體抗體融合蛋白治療中的消長及其意義的研究. 西安: 第四軍醫大學, 2007.
11. 郝慧琴, 黃烽, 鄧小虎, 等. 抗腫瘤壞死因子-α 治療對強直性脊柱炎患者外周血 CD4⁺CD25⁺T 細胞調節作用的初步研究. 中華風濕病學雜志, 2007, 11(6): 328-330.
12. Suen JL, Li HT, Jong YJ, et al. Altered homeostasis of CD4(+) FoxP3(+) regulatory T-cell subpopulations in systemic lupus erythematosus. Immunology, 2009, 127(2): 196-205.
13. 程昉, 嚴定安, 何東儀, 等. 強直性脊柱炎患者外周血 CD4⁺CD25⁺調節性 T 細胞的研究. 中華風濕病學雜志, 2008, 12(12): 808-811.
14. 章圣輝, 韓義香, 吳建波, 等. 強直性脊柱炎患者外周血 CD4⁺調節性 T 細胞的變化及意義. 中華微生物學和免疫學雜志, 2008, 28(5): 445-449.
15. Toussirot E, Saas P, Deschamps M, et al. Increased production of soluble CTLA-4 in patients with spondylarthropathies correlates with disease activity. Arthritis Res Ther, 2009, 11(4): R101.
16. F?rger F, Villiger PM, Ostensen M. Pregnancy in patients with ankylosing spondylitis: do regulatory T cells play a role? Arthritis Rheum, 2009, 61(2): 279-283.
17. 黃河, 汪亞東, 孫燕燕, 等. 強直性脊柱炎患者外周血中調節性 T 細胞水平研究. 中國熱帶醫學, 2009, 9(10): 1992-1993.
18. Ciccia F, Accardo-Palumbo A, Giardina A, et al. Expansion of intestinal CD4⁺CD25(high) Treg cells in patients with ankylosing spondylitis: a putative role for interleukin-10 in preventing intestinal Th17 response. Arthritis Rheum, 2010, 62(12): 3625-3634.
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Chinese Journal of Evidence-Based Medicine

The proportion of regulatory T cells in patients with ankylosing spondylitis: a meta-analysis

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