The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis
Objective. Accumulating evidence indicates that regulatory T cells (Tregs) may be involved in the pathogenesis of ankylosing spondylitis (AS). As different markers have been used to identify Tregs, some studies on the proportions of Tregs in AS patients have generated considerable controversy. To cl...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2019/1058738 |
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| author | Na-Lin Lai Sheng-Xiao Zhang Jia Wang Jia-Qian Zhang Cai-Hong Wang Chong Gao Xiao-Feng Li |
| author_facet | Na-Lin Lai Sheng-Xiao Zhang Jia Wang Jia-Qian Zhang Cai-Hong Wang Chong Gao Xiao-Feng Li |
| author_sort | Na-Lin Lai |
| collection | DOAJ |
| description | Objective. Accumulating evidence indicates that regulatory T cells (Tregs) may be involved in the pathogenesis of ankylosing spondylitis (AS). As different markers have been used to identify Tregs, some studies on the proportions of Tregs in AS patients have generated considerable controversy. To clarify the status of Tregs in such patients, we determine the proportion changes of peripheral Tregs during development of the disease, with different cellular markers. Methods. We systematically searched Embase, PubMed, Cochrane, Web of Knowledge, FDA.gov, and Clinical Trials.gov for the studies reporting the proportion of Tregs in AS patients. Using the PRISMA guidelines, we performed a random-effects meta-analysis of the frequencies of peripheral Tregs defined in different ways. Inconsistency was evaluated using the I-squared index (I2), and publication bias was assessed by examining funnel plot asymmetry using the Begger and Egger tests. Results. A total 29 studies involving 1732 participants were included in the meta-analysis. Their conclusions of using the diversity of Tregs surface markers were inconsistent with each other. No significant difference in the proportions of Tregs was evident regardless of the definitions used [−0.709, (−1.455, 0.037, p=0.063), I2=97.3%]. Six studies used “single CD25-positive” cells as Tregs, which revealed a significant increase in AS patients compared with healthy blood donors [0.736, (0.138, 1.334), p=0.016, I2=80.7%]. Notably, the proportions of “CD4+CD25+FOXP3+,” “CD4+CD25highCD127low/−,” or “CD4+CD25+CD127low” T cells were lower in AS patients [−2.856, (−4.645, −1.066), p=0.002; −1.812, (−2.648, −0.977), p<0.001; −1.12, (−1.605, −0.635), p<0.001]. Tregs defined as “CD25high,” “CD25bright,” “CD25bright/highCD127low/−,” “CD4+FOXP3+,” “CD4+CD25highFOXP3+,” and “CD4+CD25+CD127−” did not differ in proportion between AS patients and healthy blood donors. Conclusions. The levels of Tregs varied based on the cellular identification markers used. The proportions of CD4+CD25+FOXP3+Tregs, CD4+CD25highCD127low/−, or CD4+CD25+CD127low in blood of AS patients were significantly decreased as compared with those in healthy blood donors, and our findings lend support to the idea that the Treg status of AS patients is important. And we recommend the above as the best definition of Tregs when evaluating the status of such patients. |
| format | Article |
| id | doaj-art-dccf662de2a24a8381465f5f7a949cc3 |
| institution | DOAJ |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2019-01-01 |
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| series | Journal of Immunology Research |
| spelling | doaj-art-dccf662de2a24a8381465f5f7a949cc32025-08-20T03:23:56ZengWileyJournal of Immunology Research2314-88612314-71562019-01-01201910.1155/2019/10587381058738The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-AnalysisNa-Lin Lai0Sheng-Xiao Zhang1Jia Wang2Jia-Qian Zhang3Cai-Hong Wang4Chong Gao5Xiao-Feng Li6Department of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaDepartment of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaDepartment of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaDepartment of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaDepartment of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaDepartment of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USADepartment of Rheumatology, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, Shanxi 030001, ChinaObjective. Accumulating evidence indicates that regulatory T cells (Tregs) may be involved in the pathogenesis of ankylosing spondylitis (AS). As different markers have been used to identify Tregs, some studies on the proportions of Tregs in AS patients have generated considerable controversy. To clarify the status of Tregs in such patients, we determine the proportion changes of peripheral Tregs during development of the disease, with different cellular markers. Methods. We systematically searched Embase, PubMed, Cochrane, Web of Knowledge, FDA.gov, and Clinical Trials.gov for the studies reporting the proportion of Tregs in AS patients. Using the PRISMA guidelines, we performed a random-effects meta-analysis of the frequencies of peripheral Tregs defined in different ways. Inconsistency was evaluated using the I-squared index (I2), and publication bias was assessed by examining funnel plot asymmetry using the Begger and Egger tests. Results. A total 29 studies involving 1732 participants were included in the meta-analysis. Their conclusions of using the diversity of Tregs surface markers were inconsistent with each other. No significant difference in the proportions of Tregs was evident regardless of the definitions used [−0.709, (−1.455, 0.037, p=0.063), I2=97.3%]. Six studies used “single CD25-positive” cells as Tregs, which revealed a significant increase in AS patients compared with healthy blood donors [0.736, (0.138, 1.334), p=0.016, I2=80.7%]. Notably, the proportions of “CD4+CD25+FOXP3+,” “CD4+CD25highCD127low/−,” or “CD4+CD25+CD127low” T cells were lower in AS patients [−2.856, (−4.645, −1.066), p=0.002; −1.812, (−2.648, −0.977), p<0.001; −1.12, (−1.605, −0.635), p<0.001]. Tregs defined as “CD25high,” “CD25bright,” “CD25bright/highCD127low/−,” “CD4+FOXP3+,” “CD4+CD25highFOXP3+,” and “CD4+CD25+CD127−” did not differ in proportion between AS patients and healthy blood donors. Conclusions. The levels of Tregs varied based on the cellular identification markers used. The proportions of CD4+CD25+FOXP3+Tregs, CD4+CD25highCD127low/−, or CD4+CD25+CD127low in blood of AS patients were significantly decreased as compared with those in healthy blood donors, and our findings lend support to the idea that the Treg status of AS patients is important. And we recommend the above as the best definition of Tregs when evaluating the status of such patients.http://dx.doi.org/10.1155/2019/1058738 |
| spellingShingle | Na-Lin Lai Sheng-Xiao Zhang Jia Wang Jia-Qian Zhang Cai-Hong Wang Chong Gao Xiao-Feng Li The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis Journal of Immunology Research |
| title | The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis |
| title_full | The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis |
| title_fullStr | The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis |
| title_full_unstemmed | The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis |
| title_short | The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis |
| title_sort | proportion of regulatory t cells in patients with ankylosing spondylitis a meta analysis |
| url | http://dx.doi.org/10.1155/2019/1058738 |
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