CD4 and CD3 T Cell Profiles in Systemic Lupus Erythematosus
Overview of T Cell Abnormalities in SLE
In SLE patients, CD3+ T cells show multiple phenotypic abnormalities, with approximately 45% of patients demonstrating markedly depressed CD4+ T cell levels and abnormal CD4/CD8 ratios, while CD8+ T cell percentages typically remain normal. 1
CD4+ T Cell Patterns
Quantitative Changes
Two distinct patient subgroups exist: 55% of SLE patients (Group A) maintain normal CD4+ T cell levels with normal CD4/CD8 ratios, while 45% (Group B) have significantly depressed CD4+ cells with low CD4/CD8 ratios 1
CD4+ T cells in SLE show a shift from naïve to memory phenotypes, with higher frequencies of memory T cells and lower frequencies of naïve T cells compared to healthy controls 2
CD4+ T Cell Subset Abnormalities
CD4+CD28- T cells are expanded in SLE patients and show an imbalance compared to CD4+CD28+ cells 2
Regulatory T cells (CD4+CD25+Foxp3+ Treg) are significantly decreased in SLE patients, with lower numbers correlating to higher SLEDAI scores (rs = -0.75, p < 0.0001) 3
T follicular helper (Tfh) cells and CD4+CXCR5-PD1+ T cells are expanded and associate with disease activity 2
Th1 cells and Treg cells are decreased, while Th2, Th17, and Tfh17 cells are increased 2
CD3+ T Cell Patterns
Overall CD3+ Population
CD3+ T cells in SLE demonstrate broad phenotypic anomalies across multiple subsets compared to healthy controls 2
CD3+CD4-CD8- (double negative) T cells are expanded in SLE patients, particularly the TCRαβ+ subpopulation 4
CD8+ T Cell Patterns
CD8+ T cell percentages remain normal in virtually all SLE patients 1
CD8+HLA-DR+ T cells and CD8+CD38+HLA-DR+ T cells are increased, suggesting impaired cytotoxic capacity 2
- CD8+CD38+HLA-DR+ T cells closely associate with disease activity, autoantibody titers, and renal prognosis 2
Functional Implications
Suppressor Function Defects
In Group B patients (low CD4+ counts), there is defective CD4 cell-mediated suppression that is concentration-dependent 1
In Group A patients (normal CD4+ counts), CD4 cell-mediated suppression is normal, but CD8+ suppressor cell function is defective 1
Clinical Monitoring Considerations
Severe lymphopenia (<500 cells/mm³) requires continuous assessment as it increases infection risk 5
The European League Against Rheumatism recommends monitoring lymphocyte counts alongside other immunological parameters during follow-up visits, particularly in patients on immunosuppressive therapy 5
Cellular populations (CD8+, CD3+/DR+, CD4+, CD19+, CD56+) remain practically unchanged before and after anti-pneumococcal vaccination, indicating vaccine safety 5