Low-dose interleukin-2 treatment increases the proportion of regulatory T cells in patients with rheumatic diseases: A meta-analysis
Low-dose interleukin-2 treatment increases the proportion of regulatory T cells in patients with rheumatic diseases: A meta-analysis
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DOI：
10.1016/j.autrev.2023.103270
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发表时间：
2023-01-10
影响因子：
13.6
通讯作者：
Wang，Caihong
中科院分区：
文献类型：
--
作者：
Yan，Huanhuan;Yan，Huer;Wang，Caihong
背景Treg细胞功能或数量不足引起的免疫耐受障碍是风湿性疾病发生发展的重要因素。越来越多的证据表明，ld IL-2治疗增加了患者外周血中Treg细胞的比例，但这一结论仍存在争议。为了更好地了解IL-2在风湿病领域对Treg细胞的作用和安全性，我们对相关报告进行了荟萃分析，这些报告记录了IL-2给药前后风湿病患者中Treg细胞的比例和不良事件发生率。方法系统检索PubMed、Embase、Scopus、Cochrane Library和Web of science数据库，检索截止到2022年11月15日的相关研究，确定风湿性疾病患者IL-2治疗前后外周血Treg细胞比例的相关研究。采用随机效应模型对老年性IL-2给药前后Treg细胞比例进行meta分析，并进行meta回归分析，探讨异质性。使用i平方指数（I2）评估不一致性，使用Egger检验检查漏斗图不对称性来评估发表偏倚。结果荟萃分析纳入了18项研究，涉及1608例患者。这些患者接受ld IL-2治疗后外周血Treg细胞比例显著升高[1.07 (95% CI 0.86,1.27), p < 0.001, I2= 67.3%]。然后对发表年份、疾病类型、试验类型、给药剂量和持续时间等5个变量进行meta回归。结果表明，这些变量不会导致高异质性。（p分别为0.698、0.267、0.502、0.843、0.560）。最后，统计分析显示，在治疗过程中，ld IL-2组与对照组的不良反应无差异[1.06 (95% CI 0.86,1.31),p= 0.586, I2 = 53.8%]，由于数据量小，不可靠。结论白介素-2确实增加了风湿病患者外周血Treg细胞的比例，在使用白介素-2时应考虑单次剂量和累积剂量。此外，还需要更多的老年IL-2的安全性研究。
BackgroundIt is now accepted that immune tolerance disorders caused by inadequate Treg cell function or number are important factors in the development and progression of rheumatic diseases. There is increasing evidence that ld IL-2 treatment increases the proportion of Treg cells in patients' peripheral blood, but this conclusion is still controversial. Here, we performed a meta-analysis of reports documenting the proportion of Treg cells and the rate of adverse events in patients with rheumatic disease before and after the administration of ld IL-2 to better understand its effect and safety on Treg cells in the field of rheumatic diseases.MethodsWe systematically searched PubMed, Embase, Scopus, Cochrane Library, and Web of science databases up to 15th November 2022 and identified studies that reported the proportion of peripheral blood Treg cells before and after ld IL-2 treatment in patients with rheumatic disease. Random-effects model was used to perform a meta-analysis of Treg cell proportions before and after ld IL-2 administration, and a meta-regression analysis was performed to explore heterogeneity. Inconsistency was evaluated using the I-squared index (I2), and publication bias was assessed by examining funnel plot asymmetry using the Egger tests.ResultsEighteen studies involving 1608 patients were included in the meta-analysis. The proportion of Treg cells in peripheral blood of these patients increased significantly after receiving ld IL-2 treatment [1.07 (95% CI 0.86,1.27), p < 0.001, I2= 67.3%]. Next, Meta-regression was performed for 5 variables including publish year, disease type, trail type and dosage and duration of the medication. The results suggest that these variables do not lead to high heterogeneity. (p= 0.698, 0.267, 0.502, 0.843, 0.560, respectively). And finally, statistical analysis showed no difference in adverse reactions between ld IL-2 group and control group in treatment [1.06 (95% CI 0.86,1.31),p= 0.586, I2 = 53.8%], which is unreliable because the data is so small.ConclusionsLd IL-2 does increase the proportion of peripheral blood Treg cells in patients with rheumatism, and single and cumulative doses must be considered when using ld IL-2. In addition, more studies on the safety of ld IL-2 are urgently needed.