Low-Dose IL-2 Combined with Rapamycin Efficiently Promoted Disease Remission and Recovered the Balance of Th17/Regulatory T Cells in Patients with Refractory Systemic Lupus Erythematosus

Xiaona Jing¹, Chong Gao², Liran Hao¹, Meihua Hao¹, Zhaoyun Liang¹, Xiao-Feng Li³ and Junwei Chen¹, ¹The Second Hospital of Shanxi Medical University, Taiyuan, China, ²Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, Cambridge, MA, ³Rheumatology, the Second Hospital of Shanxi Medical University, Taiyuan, China

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: T cells and systemic lupus erythematosus (SLE)

Session Information

Date: Sunday, October 21, 2018

Title: 3S110 ACR Abstract: SLE–Clinical I: Clinical Trials (970–975)

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose:To observe the clinical effect of low-dose IL-2 combined with rapamycin on the balance of Th17/Treg cells and on remission of patients with refractory SLE.

Methods: Ninety refractory SLE patients (96.7% women; mean age 35.85±12.41 years; mean duration 76.98±47.24 months) were enrolled. They were in line with the standard of ACR in 1997 and did not achieve remission by the treatment of glucocorticoid and immunosuppressant for more than one year. Low-dose IL-2 was used among these patients at a dosage of 50 WIU every day for five days and rapamycin (0.5mg each time,twice per week). At baseline, 6, 12, an 24 weeks, respectively, after the therapy combined with conventional drugs, absolute numbers of Th17 and Treg cells were assayed by flow cytometry and other clinical and laboratory data, including the dosage of corticosteroids and immunosuppressant, were collected.

Results: After 24 weeks, administration of low doses of IL-2 and rapamycin promoted 26.2% of patients with refractory SLE to achieve remission, leading to an increase in the absolute number of Treg cells from a median of 14.17 cells/µl (at week 0) to 21.66 cells/µl (at week 24) (P£¼0.001).The ratio of Th17/Treg cells showed a reduction from a median of 0.44 at week 0 to 0.29 at week 24 (P=0.029), indicating a restored balance of them. No significant differences were observed in the absolute number of Th17 cells before and after the combined treatment. At week 24, the mean dosage of prednisone, which refractory SLE patients were receiving, decreased from 18.64 mg/d to 8.80 mg/d. And the categories of DMARDs used were also reduced (P<0.001).

Conclusion: Our results suggest that refractory SLE is mainly associated with the decreased number of peripheral Treg cells but not increase in that of Th17 cells. Low-dose IL-2 combined with rapamycin treatment promoted patients with refractory SLE to achieve remission and recovered the balance The Th17 and Treg cells due to an increase in the number of Treg cells. This treatment also reduced the usage of glucocorticoid and DMARDs.

Disclosure: X. Jing, None; C. Gao, None; L. Hao, None; M. Hao, None; Z. Liang, None; X. F. Li, None; J. Chen, None.

To cite this abstract in AMA style:

Jing X, Gao C, Hao L, Hao M, Liang Z, Li XF, Chen J. Low-Dose IL-2 Combined with Rapamycin Efficiently Promoted Disease Remission and Recovered the Balance of Th17/Regulatory T Cells in Patients with Refractory Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/low-dose-il-2-combined-with-rapamycin-efficiently-promoted-disease-remission-and-recovered-the-balance-of-th17-regulatory-t-cells-in-patients-with-refractory-systemic-lupus-erythematosus/. Accessed .

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