ABSTRACT

Background

Regulatory T cells

(Tregs) play an important role in the maintenance of immunological tolerance. Tregs deficiency or suppressor functions reduction may be associated with autoimmune diseases development.

Objectives

To estimate the effect of vitamin D supplementation on Tregs level in the peripheral blood of active rheumatoid arthritis (RA) patients.

Methods

40 active RA patients were randomly assigned into two groups. Group I received methotrexate (MTX) plus hydroxychloroquine, group II received MTX, hydroxychloroquine plus vitamin D supplementation for 3 months, and 30 healthy volunteers as control group. Peripheral blood Tregs were measured at baseline and after 3 months by Flow Cytometry.

Results

At baseline, Tregs percentage was significantly decreased (p<0.001) in both RA patient groups (13.52±1.95%, 13.65±2.98% respectively), compared to controls (28.44±7.37%) with no significant difference between the two patient groups (p=0.866). After 3 months, there was a significant elevation in Tregs percentage in group II compared to group I (p<0.001). Tregs elevation was associated with significant DAS-28 score reduction (p<0.001).

Conclusion

Vitamin D appears to have important immunomodulatory functions. Vitamin D supplementation can be combined safely with traditional DMARDs to regulate the immune system.

Clinical trial registration

Tanta University Protocol Record 33846, Vitamin D Effect in Rheumatoid Arthritis, http://www.clinicaltrials.gov, NCT04472481.

中文翻译：

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维生素 D：它是否有助于活动性类风湿性关节炎患者的 Tregs。

摘要

背景

调节性 T 细胞

(Tregs) 在维持免疫耐受中起重要作用。Tregs 缺乏或抑制功能降低可能与自身免疫性疾病的发展有关。

目标

评估维生素 D 补充剂对活动性类风湿性关节炎 (RA) 患者外周血 Tregs 水平的影响。

方法

40 名活动性 RA 患者被随机分为两组。I组接受甲氨蝶呤（MTX）加羟氯喹治疗，II组接受MTX、羟氯喹加维生素D补充治疗3个月，30名健康志愿者作为对照组。在基线和 3 个月后通过流式细胞术测量外周血 Treg。

结果

在基线时，与对照组 (28.44±7.37%) 相比，两个 RA 患者组 (分别为 13.52±1.95% 和 13.65±2.98%) 的 Tregs 百分比显着降低 (p<0.001)，两个患者组之间没有显着差异 ( p=0.866）。3 个月后，与组 I 相比，组 II 的 Tregs 百分比显着升高（p<0.001）。Tregs 升高与显着的 DAS-28 评分降低相关（p<0.001）。

结论

维生素 D 似乎具有重要的免疫调节功能。维生素 D 补充剂可以与传统的 DMARD 安全地结合使用，以调节免疫系统。

临床试验注册

坦塔大学协议记录 33846，维生素 D 对类风湿性关节炎的影响，http://www.clinicaltrials.gov，NCT04472481。