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Elevated Peripheral CD161+ Treg Cells and Their Clinical Significance in Behçet Syndrome
Jiachen Li1, Weiyi Xia1, Feng Sun1
1Department of Rheumatology and Immunology, Peking University People's Hospital and Beijing Key Laboratory for Non-invasive Diagnosis and Immunotherapy of Rheumatic Diseases, Beijing, China.
Objective:
Behçet syndrome (BS) is a systemic autoimmune vasculitis characterized by immune dysregulation involving multiple immune cell subsets. CD161+ Treg cells exhibit proinflammatory properties and impair immune regulation during inflammation. This study aimed to investigate the alterations in CD161+ Treg cells in BS and their clinical relevance, particularly in disease pathogenesis and neurologic involvement.
Methods:
This prospective multicenter study included 182 patients diagnosed with BS at the three hospitals between 2018 and 2024, 166 patients with systemic lupus erythematosus (SLE) and 149 patients with rheumatoid arthritis (RA) and 114 patients with healthy controls (HCs). Demographic and clinical data were recorded. CD4+CD25highCD127lowCD161+ T cells (CD161+ Treg cells) in peripheral blood were analyzed via flow cytometry. Statistical analysis included the Wilcoxon rank-sum test, Fisher's exact test, and logistic regression, with P < 0.05 considered significant.
Results:
Patients with BS had a significantly higher proportion among total Treg cells and CD4+ T cells, as well as higher absolute number of CD161+ Treg cells compared to HCs. CD161+ Treg cell levels negatively correlated with Foxp3+ Treg cells and positively correlated with Teff cells. Patients with BS had higher absolute number of CD161+ Treg cells than that in patients with SLE and in patients with RA. Moreover, patients with BS with higher erythrocyte sedimentation rate or C-reactive protein or with neurologic involvement exhibited higher CD161+ Treg cells, which were identified as a risk factor for neurologic involvement. Among 41 patients with BS observed after treatment, CD161+ Treg cells significantly decreased, correlating with reduced disease activity.
Conclusion:
Patients with BS exhibit an increased CD161+ Treg cells in peripheral blood, which may contribute to immune dysregulation and neurologic involvement. The reduction of CD161+ Treg cells following treatment suggests their potential role as a biomarker for disease activity in BS.
