الفهرس 
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Abstract
Systemic lupus erythematosus (SLE) is characterized by production of a wide range of autoantibodies that can induce inflammation associated with immunity in various tissues and organs. It is believed that breakdown of immune endurance is one of the major mechanisms leading to the production of antibodies by B cells resulting in inflammation when linked to the self-antigens and consequent tissue damage.
Recent strong evidence has shown that T cells are indeed critical for the development of SLE, as they promote the autoantibodies production by providing significant support for B cells by stimulating them for differentiation, proliferation and maturation of self-antibodies expressed by B-cells.
Therefore, SLE is currently thought to be a T-cell controlled state. In fact, the molecules expressed on T-cells are targeted and their signaling pathways may be one of the possible therapeutic strategies in SLE.
Compared to healthy volunteers, a number of studies have shown that T cells isolated from SLE patients are abnormal in their phenomena and functions.
The aim of this study was to evaluate senescent CD4+/CD28 null and conventional CD4+/CD28+ T lymphocyte populations in patients with SLE with and without nephritis.
The study involved 51 SLE patients and 15 apparently healthy individuals as a control group.
They were categorized into 3 main groups
group (I): Included 21 SLE with nephritis subjects, (20 female,1 male).
group (II): Included 30 SLE without nephritis patients(29 females,1 male)
group (III): Included apparently healthy 15 control subjects, (all of them are females)
All patients and control were enrolled in this study subjected to
Routine laboratory tests including: complete blood count (CBC), lipid profile, liver profile, antinuclear antibodies (ANA) and anti double stranded DNA (dsDNA) and high-sensitivity C-reactive protein (hs CRP) by turbidimetry.
Renal biopsy was done for SLE with nephritis.
Systemic lupus erythematosis disease activity index (SLEDAI) score
Radiological investigations for patients and controls
Detection of expansion CD4/CD28 T lymphocyte populations was performed by flowcytometry.
The results of this study were tabulated, statistically analyzed and graphically represented.
The present study revealed the following results
In the present study, statistical analysis by comparison between the three studied groups; SLE with nephritis, SLE without nephritis and controls according to different T cell populations; CD4+/CD28null and CD4+/CD28+ T cells, revealed that CD4+/CD28+ T lymphocytes were significantly higher in SLE with nephritis than controls (p=0.009). There was no statistically significant difference in CD4+/CD28 null T cell population among the 3 studied groups (p>0.05).
In SLE with nephritis group, logistic regression revealed that creatinine was the independent predictor for CD4+/CD28+ T lymphocyte population size (p=0.004).
In our study, comparing between SLE patient group and control regard to CRP revealed highly significant difference (p <0.001). CD28+CD4 null T cells were positively correlated with CRP, ESR, ALT, PT%, platelets, neutophilic count and SLEDAI score in lupus group without nephritis. While these group of cells were positively correlated with creatinine level and renal biopsy in lupus nephritis patients.
Double positive T lymphocytes were positively correlated with creatinine level, WBCs count and renal biopsy in SLE nephritis. But in lupus without nephritis, these cells were correlated with lymphocytic count and INR only.