[Regulatory T cells and systemic autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis, primary Sjögren's syndrome]

Rev Med Interne. 2010 Feb;31(2):116-27. doi: 10.1016/j.revmed.2009.03.364. Epub 2009 Dec 3.
[Article in French]

Abstract

Regulatory/suppressor T cells (Tregs) maintain immunologic homeostasis and prevent autoimmunity. They are the guardians of dominant tolerance. Recent research reveals quantitative and/or functional defect of Tregs in systemic autoimmune diseases. In this article, past and recent studies of Tregs in human systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and primary Sjögren's syndrome (pGSS) are reviewed. Most studies report that Tregs are decreased in peripheral blood of subjects with active SLE. A population of CD4+CD25-Foxp3+ is specifically described in SLE. Tregs functions are still discussed. Tregs counts in peripheral blood of RA patients vary across studies. Enrichment of synovial fluid in Tregs contrasts with inflammation. Tregs suppressive effects are altered in vivo in RA secondary to proinflammatory cytokines environment and resistance of effector T cells to Tregs. In pGSS, the conflicting place of Tregs in the balance prevention of autoimmunity/antitumor immunity is unspecified. Immunosuppressive treatments, like corticosteroids and anti-TNF, modulate Tregs cells population. There is increasing interest in the use of Tregs as a biological therapy to preserve and restore tolerance to self-antigen. However, difficulties to characterize these lymphocytes and controversies in the results of studies refrain their use in current clinical practice.

MeSH terms

  • Antigens, CD / blood
  • Arthritis / blood
  • Arthritis / immunology
  • Arthritis / pathology
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / immunology*
  • Autoimmune Diseases / blood
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / pathology
  • CD4 Antigens / immunology
  • Humans
  • Immunosuppression Therapy / methods
  • Interleukin-10 / immunology
  • Interleukin-2 Receptor alpha Subunit / immunology
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / immunology*
  • Sjogren's Syndrome / blood
  • Sjogren's Syndrome / immunology*
  • Sjogren's Syndrome / pathology
  • T-Lymphocytes, Regulatory / immunology*
  • T-Lymphocytes, Regulatory / pathology
  • Thymus Gland / immunology

Substances

  • Antigens, CD
  • CD4 Antigens
  • Interleukin-2 Receptor alpha Subunit
  • Interleukin-10