Reduced proportions of natural killer T cells are present in the relatives of lupus patients and are associated with autoimmunity.
BACKGROUND
Systemic lupus erythematosus is a genetically complex disease. Currently, the precise allelic polymorphisms associated with this condition remain largely unidentified. In part this reflects the fact that multiple genes, each having a relatively minor effect, act in concert to produce disease. Given this complexity, analysis of subclinical phenotypes may aid in the identification of susceptibility alleles. Here, we used flow cytometry to investigate whether some of the immune abnormalities that are seen in the peripheral blood lymphocyte population of lupus patients are seen in their first-degree relatives.


METHODS
Peripheral blood mononuclear cells were isolated from the subjects, stained with fluorochrome-conjugated monoclonal antibodies to identify various cellular subsets, and analyzed by flow cytometry.


RESULTS
We found reduced proportions of natural killer (NK)T cells among 367 first-degree relatives of lupus patients as compared with 102 control individuals. There were also slightly increased proportions of memory B and T cells, suggesting increased chronic low-grade activation of the immune system in first-degree relatives. However, only the deficiency of NKT cells was associated with a positive anti-nuclear antibody test and clinical autoimmune disease in family members. There was a significant association between mean parental, sibling, and proband values for the proportion of NKT cells, suggesting that this is a heritable trait.


CONCLUSIONS
The findings suggest that analysis of cellular phenotypes may enhance the ability to detect subclinical lupus and that genetically determined altered immunoregulation by NKT cells predisposes first-degree relatives of lupus patients to the development of autoimmunity.
Wither
Joan
J
Arthritis Centre of Excellence, Division of Genetics and Development, Toronto Western Hospital Research Institute, University Health Network, Toronto, Ontario, Canada. jwither@uhnres.utoronto.ca
Cai
Yong-chun
YC
Lim
Sooyeol
S
McKenzie
Tamara
T
Roslin
Nicole
N
Claudio
Jaime O
JO
Cooper
Glinda S
GS
Hudson
Thomas J
TJ
Paterson
Andrew D
AD
Greenwood
Celia M T
CM
Gladman
Dafna
D
Pope
Janet
J
Pineau
Christian A
CA
Smith
C Douglas
CD
Hanly
John G
JG
Peschken
Christine
C
Boire
Gilles
G
Fortin
Paul R
PR
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D015703:Antigens, CD / Q000378:metabolism; D015551:Autoimmunity / Q000276:immunology*; D005190:Family; D005260:Female; D005434:Flow Cytometry; D020022:Genetic Predisposition to Disease; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000235:genetics* / Q000276:immunology*; D008297:Male; D055611:Natural Killer T-Cells / Q000276:immunology*; D010375:Pedigree; D010641:Phenotype
D000974:Antibodies, Antinuclear; D015703:Antigens, CD
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