Lymphocyte subset clustering analysis in treatment-naive patients with systemic lupus erythematosus
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ORIGINAL ARTICLE
Lymphocyte subset clustering analysis in treatment-naive patients with systemic lupus erythematosus Zhimin Lu 1,2
&
Weiping Li 1,3
&
Yawei Tang 1
&
Zhanyun Da 2
&
Xia Li 1
Received: 8 April 2020 / Revised: 1 October 2020 / Accepted: 26 October 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objectives The aim of the study is to identify clusters of lymphocyte subsets within treatment-naive systemic lupus erythematosus (SLE) patients and evaluate the potential association of these clusters with disease activities. Methods We conducted a cross-sectional study of consecutive 143 treatment-naive SLE patients in the Affiliated Hospital of Nantong University, China. We used hierarchical cluster analysis to classify individuals into clusters based on circulating lymphocyte subset proportions (CD3+CD4+T cell, CD3+CD8+T cell, CD19+B cell, and CD3-CD16 + CD56 NK cell) via R software. Demographic variables, clinical manifestations, laboratory variables, and disease activities were compared among clusters. Results The SLE patients (median age 35 (26–48) years, 90.9% female) were divided into four clusters. The clustering features were as follows: cluster 1 (B high), cluster 2 (CD4 high), cluster 3 (CD8 high), and cluster 4 (NK high). SLE patients in cluster 1 showed the highest incidence of arthritis (70.6%, 34.2%, 48.3%, and 42.9% in clusters 1, 2, 3, and 4, respectively; P = 0.046), and patients in cluster 3 and cluster 4 showed significantly a higher incidence of nephritis (35.3%, 25.0%, 48.3%, and 61.9% in in clusters 1, 2, 3, and 4, respectively; P = 0.008). Patients in cluster 2 suffered from lower SLE Disease Activity Index (SLEDAI) score (12.1 ± 5.0, 10.3 ± 5.6, 12.2 ± 4.6, and 14.4 ± 7.3 in clusters 1, 2, 3, and 4, respectively; P = 0.046). Regression analysis indicated that, compared with patients in cluster 2, patients in cluster 1 exhibited higher rate of arthritis (OR 4.53, 95% CI 1.38– 14.86, P = 0.013), while patients in cluster 3 (OR 2.85, 95%CI 1.15–7.08, P = 0.024) and cluster 4 (OR 4.93, 95%CI 1.76–13.85, P = 0.002) exhibited higher rate of nephritis. Conclusion This study supports the existence of lymphocyte subset clusters with different clinical features in treatment-naive SLE patients, which could help to differentiate between various subsets of SLE. Key Points • Lymphocyte subsets may occur in a pattern of cluster in treatment-naive SLE patients.
Keywords Systemic lupus erythematosus . Lymphocyte subsets . Cluster analysis . Disease activity Zhimin Lu and Weiping Li are the co-first authors. * Zhanyun Da [email protected] * Xia Li [email protected] Weiping Li https://orcid.org/0000-0002-1843-9906 1
Department of Immunology, College of Basic Medical Science, Dalian Medical University, Dalian, People’s Republic of China
2
Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China
3
Department of Hematopathology, The Second Hospital of Dalian Medical University, Dalian, People’s Republi
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