Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Peripheral CD4+CD28null T-cells are a subset of long-lived cytotoxic CD4+ T-cells with pro-inflammatory functions, and they are increased in autoimmune and cardiovascular diseases. Prolactin has several pro-inflammatory functions, and in patients with SLE has been associated with disease activity, pro-inflammatory body mass distribution and disease damage. The aim of this study was to determine whether prolactin levels are independently associated with this T-cell subset in SLE patients.
Methods: This cross-sectional study was conducted in consecutive SLE patients seen in our Rheumatology Department from September 2013 to April 2014. An interview, medical records review, physical examination and laboratory tests were performed. SLE was defined using the 1997 revised and updated ACR criteria. Prolactin levels were recorded in ng/ml. Disease activity was ascertained using the SLEDAI, disease damage with the SLICC/ACR damage index (SDI) and comorbidities with the Charlson Comorbidity Index (CCI). Use of prednisone was recorded as current dose and total time of exposure. Use of antimalarials and immunosuppressives was recorded as current, past or never. CD4+CD28null frequency was analyzed by flow-cytometry. The association of prolactin levels and CD4+CD28null T-cells was examined by univariable and multivariable linear regression models, adjusting for age at diagnosis, gender, disease duration, CCI, SLEDAI, SDI and use of prednisone, antimalarials and immunosuppressive drugs. All analyses were performed using SPSS 21.0.
Results: One hundred and four patients were evaluated; they were representative of the entire cohort (n=268); their mean (SD) age at diagnosis was 36.5 (13.6) years, 96 (92.3%) were female; all patients were mestizo (mixed Caucasian and Amerindian ancestry). Disease duration was 7.2 (6.5) years. The SLEDAI was 5.3 (3.9), the SDI 0.9 (1.3) and the CCI 1.4 (0.8). The current dose of prednisone was 7.0 (5.2) mg/d and the total time of exposure to prednisone was 6.8 (7.0) years; 82 (78.8%) and 12 (11.5%) were current and former users of antimalarials. Forty-seven (45.2%) and 26 (25.0%) were current and former users of immunosuppressive drugs. Prolactin levels were 20.6 (19.7) ng/ml. The percentage of CD4+CD28null was 17.7 (15.1) In the univariable analysis, prolactin levels were positively associated with a higher percentage of CD4+CD28null (B= 0.26, 95% IC= 0.12-0.40; p<0.001) and remained associated in the multivariable analysis (B=0.20, 95%CI= 0.04-0.37, p=0.018).
Conclusion: In SLE patients, prolactin levels are independently associated with a higher percentage of CD4+CD28null. These data support the role of prolactin as a proinflammatory hormone among autoimmune diseases and could explain its association with damage accrual.
To cite this abstract in AMA style:Ugarte-Gil M, Sánchez-Zúñiga C, Gamboa-Cardenas RV, Aliaga-Zamudio M, Zevallos F, Tineo-Pozo G, Cucho-Venegas JM, Mosqueira-Riveros A, Perich-Campos R, Alfaro-Lozano J, Medina M, Rodriguez-Bellido Z, Alarcon GS, Pastor-Asurza CA. Prolactin Level Is Independently Associated with Circulating CD4+CD28null in Systemic Lupus Erythematosus Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/prolactin-level-is-independently-associated-with-circulating-cd4cd28null-in-systemic-lupus-erythematosus-patients/. Accessed May 8, 2021.
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