title: The associations of circulating CD4+CD25high regulatory T cells and TGF-β with disease activity and clinical course in patients with adult-onset Still's disease.
abstract: OBJECTIVE
  To determine circulating levels of CD4(+)CD25(high) regulatory T (Treg) cells and transforming growth factor-β (TGF-β) in patients with adult-onset Still's disease (AOSD) and to examine the associations with disease activity and clinical course of this disease.
  
  
  METHODS
  The frequencies of circulating CD4(+)CD25(high) Treg cells in 52 active AOSD patients, 42 active systemic lupus erythematosus (SLE) patients, and 22 healthy controls (HCs) were determined using flow cytometry analysis. Levels of serum TGF-β and soluble interleukin-2 receptor (sIL-2R) were measured by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Significantly lower levels of circulating CD4(+)CD25(high) Treg cells and serum TGF-β were found in AOSD patients and SLE patients than those found in HCs. Levels of circulating CD4(+)CD25(high) Treg cells and TGF-β were inversely correlated with disease activity scores for AOSD patients and SLE patients. Circulating CD4(+)CD25(high) Treg cell frequencies were positively correlated with serum TGF-β levels for patients with both diseases. Levels of circulating CD4(+)CD25(high) Treg cells and TGF-β significantly increased, paralleling clinical remission and the decrease in levels of C-reactive protein and soluble interleukin-2 receptor after effective therapy in AOSD patients. AOSD patients with monocyclic course had significantly higher levels of circulating CD4(+)CD25(high) Treg cells and TGF-β compared to those with polycyclic and chronic articular course.
  
  
  CONCLUSIONS
  Diminished levels of circulating CD4(+)CD25(high) Treg cells and TGF-β, and inverse correlation with disease activity in patients with AOSD and SLE might be involved in the pathogenesis of both diseases. Increased levels of circulating CD4(+)CD25(high) Treg cells or TGF-β might be associated with a favorable clinical course in AOSD patients.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Hsieh
authors.forename: Chi-Chen
authors.initials: CC
authors.lastname: Lin
authors.forename: Joung-Liang
authors.initials: JL
authors.lastname: Lan
mesh_terms: D000328:Adult; D015704:CD4 Antigens / Q000096:biosynthesis* / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D016706:Still's Disease, Adult-Onset / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000378:metabolism; D016212:Transforming Growth Factor beta / Q000096:biosynthesis / Q000097:blood*; D055815:Young Adult
chemical_list: D015704:CD4 Antigens; C508017:IL2RA protein, human; D053645:Interleukin-2 Receptor alpha Subunit; D016212:Transforming Growth Factor beta