The contribution of immune regulation to the etiology of systemic lupus erythematosus (SLE) is poorly understood. Using the monoclonal antibodies OKT4 and OKTS, we quantitated, by flow cytometry, T inducer/ helper and T cytotoxicfsuppressor cells in patients with SLE. Serologically active patients, who had clinical manifestations such as arthritis or rash and were not receiving prednisone, were characteristically lymphopenic due to a marked reduction in OKT4+ cells. Prednisone therapy produced the same phenomenon. Untreated patients, who were serologically inactive, demonstrated no abnormalities. These studies have thus revealed two presumably independent factors that can produce similar immunoregulatory aberrations.Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by excessive immunoglobulin and autoantibody production. Although B cell function is increased, T cell functions which include delayed hypersensitivity (1-3, mitogenic reactivity (6,7), generation of antigen-specific reactivities (8), and development of nonspecific suppressor (14).We studied 28 patients with SLE who were divided into groups based on corticosteroid therapy and serologic evidence of disease activity. We will describe clinically significant abnormalities in the absolute number and relative proportions of immunoregulatory T cell subsets based upon this classification.
PATIENTS AND METHODSPatients. This study included 28 patients (24 females, 4 males) with SLE according to the American Rheumatism Association ( M A ) preliminary criteria (15). Two to 3 patients were randomly selected in the lupus clinic visits each month from April 1981 to April 1982. These patients were then separated into 2 groups based on existing therapy, one receiving more than 10 mg prednisone per day, the other receiving 10 mg or less of prednisone per day. A special attempt was made to isolate newly diagnosed lupus patients being treated with 10 mg or less prednisone per day. During this 1-year period, 11 newly diagnosed patients were seen, but only 6 had 4 or more ARA preliminary criteria; of these 6, only 5 were treated with less than 10 mg prednisone per day.Control groups consisted of 16 women and 5 men with scleroderma and 16 patients with lepromatous leprosy. They will be described in detail elsewhere. Normal individ-