Objective To analyze the changes of CD4+CD28null T cells and platelet-bound complement cleavage products(PC4d)in patients with active and inactive systemic lupus erythematosus(SLE)and normal controls,and evaluate their signifi-cance as biomarkers for judging disease activity and therapeutic effect.Methods This was a single-center,observational cohort study in our hospital.The study time is from January 2021 to June 2022.The subjects were 90 SLE patients aged 15-70 and 22 healthy controls.Calculate systemic lupus erythematosus disease activity index(SLEDAI)to evaluate the overall disease activity;Patients with SLEDAI score>4 were regarded as active SLE,and the rest were classified as inactive SLE.The lev-els of CD4+CD28null T cells and PC4d were analyzed by flow cytometry.Results Compared with the healthy control group,the patients in active SLE group were younger,and the levels of CD4+CD28null T and PC4d were higher.The differences in WHO classification,SLEDAI,and CD4+CD28null T cells between patients with active SLE and those with inactive SLE were statisti-cally significant.The levels of CD4+CD28null T and PC4d were positively correlated with SLEDAI(r=0.214,P<0.05;r=0.410,P<0.05).The difference in the percentage of CD4+CD28null T cells across different WHO classifications was statistically significant.and the percentage of CD4+CD28null T cells in WHO grade 5 was significantly higher than that in other grades.Com-pared with the group with treatment response,the levels of CD4+CD28null T and PC4d in the group without treatment response increased significantly.ROC curve showed that the AUC values of CD4+CD28null T and PC4d in predicting the treatment re-sponse of SLE in active stage were 0.759(95%CI:0.604-0.914)and 0.923(95%CI:0.832-1.000),respectively.Conclusion The expansion of CD4+CD28null T cell and the increase of PC4d level are closely related to the disease activity of SLE patients,and they can be used as potential candidate biomarkers to predict the treatment response of active SLE patients.
systemic lupus erythematosusactive phaseCD4+CD28null T cellsplatelet-bound complement cleavage productstreatment response
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