Longitudinal analysis at pre- and post-flare of T peripheral helper and T follicular helper subsets in patients with systemic lupus erythematosus.

We focused to analyze the time-course changes at pre- and post-flare of T peripheral helper (Tph) cells and circulating T follicular helper (Tfh) cells in the blood of patients with systemic lupus erythematosus (SLE) with lupus low disease activity state (LLDAS) before flare. This study included inactive (n=29) and active (n=55) patients with SLE. Tph subsets, Tfh subsets, CD11c Active SLE patients exhibited the increased frequency of Tph1, Tph2, Tfh1, and Tfh2 subsets when compared to inactive patients, but no clear changes in the other subsets. During the treatment with medications, Tph1, Tph2, and Tfh2 subsets were significantly reduced along with disease activity and Tph1 and Tph2 subsets were positively correlated with SLE disease activity index (SLEDAI). The time course analysis of patients at pre- and post-flare revealed that in the patients at LLDAS before flare, Tph subsets and Tfh subsets were relatively low levels. At the flare, Tph cells, particularly Tph1 and Tph2 subsets, were increased and correlated with SLEDAI. Furthermore, the blood levels of IFN-α2a, IFN-γ, and IFN-λ1 were low in the patients with LLDAS before flare but these IFNs, particularly IFN-λ1, were increased along with flare. Increased frequency of Tph1 and Tph2 subsets and elevated levels of serum IFN-λ1 are presumably critical for triggering of flare in SLE.

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Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mitsuhiro Akiyama: Asahikasei Pharma Corp., Astellas Pharma Inc., Boehringer Ingelheim Co., Ltd., Eli Lilly Japan KK., Pfizer Japan Inc., and UCB Japan Co., Ltd. Tsutomu Takeuchi: AbbVie GK, Bristol-Myers KK, Chugai Pharmaceutical Co., Ltd. Noriyasu Seki, Hideto Tsujimoto, Shuhei Tanemura, Kunio Sugahara, a nd Kenji Chiba : Mitsubishi Tanabe Pharma Corporation employee