The Proportion of Regulatory T Cells in Patients with Ankylosing Spondylitis: A Meta-Analysis

• Published in: Journal of immunology research 2019, Vol.2019 (2019), p.1-11
• Main Authors: Li, Xiaofeng, Wang, Caihong, Zhang, Jia-Qian, Wang, Jia, Zhang, Sheng-Xiao, Lai, Na-Lin, Gao, Chong
• Format: Article
• Language: English
• Subjects: Ankylosing spondylitis; Biomarkers; Blood & organ donations; Blood donors; CD25 antigen; CD4 antigen; Clinical trials; Disease Susceptibility - immunology; Foxp3 protein; Humans; Immunology; Immunophenotyping; Immunoregulation; Lupus; Lymphocyte Count; Lymphocytes; Lymphocytes T; Meta-analysis; Multiple sclerosis; Pathogenesis; Regulation; Review; Rheumatoid arthritis; Severity of Illness Index; Spondylitis; Spondylitis, Ankylosing - diagnosis; Spondylitis, Ankylosing - etiology; Spondylitis, Ankylosing - metabolism; Studies; Surface markers; T-Lymphocyte Subsets - immunology; T-Lymphocyte Subsets - metabolism; T-Lymphocytes, Regulatory - immunology; T-Lymphocytes, Regulatory - metabolism
• ISSN: 2314-8861; 2314-7156; 2314-7156
• DOI: 10.1155/2019/1058738

Objective. Accumulating evidence indicates that regulatory T cells (Tregs) may be involved in the pathogenesis of ankylosing spondylitis (AS). As different markers have been used to identify Tregs, some studies on the proportions of Tregs in AS patients have generated considerable controversy. To clarify the status of Tregs in such patients, we determine the proportion changes of peripheral Tregs during development of the disease, with different cellular markers. Methods. We systematically searched Embase, PubMed, Cochrane, Web of Knowledge, FDA.gov, and Clinical Trials.gov for the studies reporting the proportion of Tregs in AS patients. Using the PRISMA guidelines, we performed a random-effects meta-analysis of the frequencies of peripheral Tregs defined in different ways. Inconsistency was evaluated using the I-squared index (I2), and publication bias was assessed by examining funnel plot asymmetry using the Begger and Egger tests. Results. A total 29 studies involving 1732 participants were included in the meta-analysis. Their conclusions of using the diversity of Tregs surface markers were inconsistent with each other. No significant difference in the proportions of Tregs was evident regardless of the definitions used [−0.709, (−1.455, 0.037, p=0.063), I2=97.3%]. Six studies used “single CD25-positive” cells as Tregs, which revealed a significant increase in AS patients compared with healthy blood donors [0.736, (0.138, 1.334), p=0.016, I2=80.7%]. Notably, the proportions of “CD4+CD25+FOXP3+,” “CD4+CD25highCD127low/−,” or “CD4+CD25+CD127low” T cells were lower in AS patients [−2.856, (−4.645, −1.066), p=0.002; −1.812, (−2.648, −0.977), p