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. 2022 Sep 29:13:988512.
doi: 10.3389/fphar.2022.988512. eCollection 2022.

Imbalance of helper T cell type 1, helper T cell type 2 and associated cytokines in patients with systemic lupus erythematosus: A meta-analysis

Shate Xiang  1 , Jingjing Zhang  1 , Mengge Zhang  1 , Suhai Qian  1 , Rongyun Wang  1 , Yao Wang  1 , Yingshi Xiang  2 , Xinghong Ding  1
Affiliations

Imbalance of helper T cell type 1, helper T cell type 2 and associated cytokines in patients with systemic lupus erythematosus: A meta-analysis

Shate Xiang et al. Front Pharmacol. .

Abstract

Objective: Th1 and Th2 cells and their associated cytokines function in the pathogenesis of systemic lupus erythematosus (SLE), but their exact roles are uncertain. We performed a meta-analysis to examine the relationship of these cells and cytokines with SLE. Methods: Multiple databases were searched to identify publications that reported the percentages of Th1 and Th2 cells and their associated cytokines in SLE patients and healthy controls (HCs). Meta-analysis was performed using Stata MP version 16. Results: SLE patients had a lower percentage of Th1 cells, a higher percentage of Th2 cells, and higher levels of Th1- and Th2-associated cytokines than HCs. SLE treatments normalized some but not all of these indicators. For studies in which the proportion of females was less than 94%, the percentage of Th2 cells and the level of IL-10 were higher in patients than HCs. SLE patients who had abnormal kidney function and were younger than 30 years old had a higher proportion of Th1 cells than HCs. SLE patients more than 30 years old had a higher level of IL-6 than HCs. Conclusion: Medications appeared to restore the balance of Th1 cells and other disease indicators in patients with SLE. Gender and age affected the levels of Th1 and Th2 cells, and the abnormally elevated levels of Th2 cells appear to be more pronounced in older patients and males. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022296540].

Keywords: cytokines; helper T cell type 1; helper T cell type 2; meta-analysis; systemic lupus erythematosus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Forest plot of the percentage change of Th1 cells in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 13 studies, and the other four results show meta-analyses of different subgroups according to medication use. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 2
FIGURE 2
Forest plot of the percentage change of Th2 cells in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 8 studies, and the other two results show meta-analyses of subgroups according to the percentage of females. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 3
FIGURE 3
Forest plot of the percentage change of Th1 cells in SLE patients with abnormal kidney function compared with normal kidney function. The overall results (bottom) show the meta-analysis of 4 studies, and the other two results show meta-analyses of subgroups according to patient age. Abnormal: SLE patients with abnormal kidney function. Normal: SLE patients with normal kidney function.
FIGURE 4
FIGURE 4
Forest plot of the ratio change of Th1/Th2 cells in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 5 studies, and the two other results show meta-analyses of subgroups according to medication use. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 5
FIGURE 5
Forest plot of the concentration change of IFN-γ in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 10 studies, and the other two results show meta-analyses of subgroups according to medication use. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 6
FIGURE 6
Forest plot of the concentration change of TNF-α in SLE patients compared with HCs. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 7
FIGURE 7
Forest plot of the concentration change of IL-2 in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 4 studies, and the other two results show meta-analyses of two subgroups according to glucocorticoid use. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 8
FIGURE 8
Forest plot of the concentration change of IL-10 in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 10 studies, and the other two results show meta-analyses of subgroups according to the percentage of patients with active disease. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 9
FIGURE 9
Forest plot of the concentration change of IL-6 in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 6 studies, and the other two results show meta-analyses of subgroups according to patient age. SLE, systemic lupus erythematosus; HCs, healthy controls.
FIGURE 10
FIGURE 10
Forest plot of the concentration change of IL-4 in SLE patients compared with HCs. The overall results (bottom) show the meta-analysis of 7 studies, and the other three results show meta-analyses of subgroups according to the percentage of females. SLE, systemic lupus erythematosus; HCs, healthy controls.
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