Role of T-helper/T-Cytotoxic Cells as Biomarkers of Lupus Nephritis

Systemic lupus erythematosus is typical systemic autoimmune disease described by various, multisystem involvement & production of array of autoantibodies. Lupus nephritis is prevalent & severe manifestations of SLE affecting forty–seventy percent of all SLE studied cases & is significant reason for morbidity & hospital admissions. T lymphocytes have pivotal role in development of autoimmune disease & subsequent damage to target organs.   Aim to determine the role of T-helper (CD3+\CD4+), T-cytotoxic (CD3+/CD8+) lymphocytes in peripheral blood as biomarkers for diagnosis of lupus nephritis. Research was conducted on100 individuals including fifty SLE studied cases (Group I) diagnosed according to 2012 Systemic Lupus International Collaborating Clinics criteria and 50 matched healthy control individuals (Group II). There was remarkably significant decrease in mean ± SD of CD4%  in group I (42.8 ± 12.3) when compared with group II (60.5 ± 8.0) with (p-value < 0.001).There was remarkably significant increase in mean ± SD of CD8% in group I (49.9 ± 12.3) when compared with group II (32.5 ± 5.8) with (p-value < 0.001).There was remarkably significant increase in mean ± SD of double negative %  in group I (6.29 ± 1.49) when compared with group II (3.33 ± 0.96) with (p-value < 0.001).There was remarkably significant reduction in mean ± SD of CD4 / CD8 ratio in group I (0.95 ± 0.52) when compared with group II (1.94 ± 0.57) with (p-value < 0.001).Double negative % can significantly diagnose SLE cases with p value <0.001, AUC 96.2%, sensitivity 86% & specificity 96% when using cutoff point 4.95%.CD4%/CD8% ratio can significantly diagnose SLE cases with p value <0.001, AUC 91.4%, sensitivity 90% & specificity 82% when using cutoff point 1.5. CD4%/CD8% ratio and double negative T cells can be used as diagnostic test for SLE patients developing lupus nephritis.