title: FOXP3+ and CD39+ regulatory T cells in subtypes of cutaneous lupus erythematosus.
abstract: BACKGROUND
  Lupus erythematosus (LE) is an autoimmune disease in which regulatory T cells play a pathogenetic role.
  
  
  OBJECTIVE
  We aimed to assess and compare the quantities of lesional Tregs in subtypes of cutaneous LE (CLE) including chronic discoid LE (CDLE), LE tumidus (LET) and subacute CLE (SCLE).
  
  
  METHODS
  Thirty-nine patients with CLE were enrolled in the study. Immunohistochemistry was performed for CD4, CD8, FOXP3 and CD39.
  
  
  RESULTS
  We studied nine CDLE patients, 21 LET patients and nine patients with SCLE. SCLE lesions [37 (0-134)] showed a significantly (P = 0.024) decreased percentage of CD4+ cells when compared with CDLE [125 (0-146)] and LET [124 (0-240)] lesions. Moreover, the CD4/CD8 ratio in SCLE lesions [0.7 (0.5-1.8)] was significantly (P = 0.027) decreased when compared with CDLE [1.9 (1.5-2.8)] and LET [1.6 (0.8-2.9)] lesions. FOXP3 immunopositivity was significantly (P = 0.017) decreased in LET [0 (0-6)] and SCLE [1 (0-2)] lesions when compared with CDLE [6 (0-38)]. Moreover, in LET [2 (0-6)] and SCLE [2 (0-2)], we observed a significantly (P = 0.0049) diminished CD39-immunoreactivity when compared with CDLE [4 (2-12)]. CD4+ cell count is a significant (P = 0.0133) negative predictor for the diagnosis of SCLE (Odds ratio 0.978, 95% CI 0.960-0.99).
  
  
  CONCLUSIONS
  Our data indicate that there are differences in quantities of lesional T helper cells, CD4/CD8 ratio and Tregs among subtypes of CLE. Interestingly, a more significant decrease in Tregs, which likely reflects greater loss of immune-tolerance, is observed in the more photosensitive subtypes of CLE such as SCLE and LET.
authors: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors: T
authors: T
authors: Gambichler
authors: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors: J
authors: J
authors: Pätzholz
authors: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors: L
authors: L
authors: Schmitz
authors: Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.
authors: N
authors: N
authors: Lahner
authors: Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth Hospital, Oberhausen, Germany.
authors: A
authors: A
authors: Kreuter
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD; D001081:Apyrase; D015704:CD4 Antigens / Q000032:analysis; D016516:CD4-CD8 Ratio; D016827:CD8 Antigens / Q000032:analysis; D005260:Female; D051858:Forkhead Transcription Factors; D006801:Humans; D007111:Immunity, Cellular; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis / Q000276:immunology*; D008179:Lupus Erythematosus, Discoid / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D050378:T-Lymphocytes, Regulatory / Q000737:chemistry*
chemical_list: D015703:Antigens, CD; D015704:CD4 Antigens; D016827:CD8 Antigens; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D001081:Apyrase; C067869:CD39 antigen