The characteristics and risk factors of cerebrovascular events in young systemic lupus erythematosus patients: A case-control study.

OBJECTIVES: We clarified the characteristics and risk factors of CVEs in young SLE patients. METHOD: We retrospectively reviewed the medical records of patients younger than 50 years of age diagnosed with SLE and first CVEs from 1995 to 2020 in a tertiary medical center in Taiwan. We collected data on the patient characteristics before the CVE and reviewed the laboratory data obtained during the period. At a ratio of 1:3, cases and controls were matched with sex, SLE diagnosis age, diagnosis year, and SLE duration. RESULTS: We enrolled 43 CVE SLE patients and matched 129 non-CVE SLE controls. The median age at the time of the CVE was 39 years. Around 70% of young-aged CVE involved the cerebral lobes of frontal (∼30%), parietal (∼20%), occipital (∼10%), and temporal (∼10%). The peak incidence period for hemorrhagic CVE was within 1st year of SLE diagnosis (37%); in contrast, during the 2nd to 5th year of SLE diagnosis (25%) for ischemia CVEs. Hyperlipidemia (odds ratio [OR] = 19.36, p = 0.002), anti-phospholipid syndrome (APS) (OR = 41.9, p = 0.0068), a lower hemoglobin level (OR = 0.66, p = 0.0192), and a higher SLE Disease Activity Index (SLEDAI-2k) score (OR = 1.22, p = 0.0019) were independent risk factors for CVEs in young SLE patients. CONCLUSION: Hyperlipidemia, APS, low Hb level, and high SLEDAI-2k significantly increase the risk of young-aged SLE patients developing CVE.

γδ T Cells and Allergic Diseases.

Gamma-delta (γδ) T cells play an essential role in allergic diseases and have emerged as a potential treatment target in recent decades. To clarify the effects of γδ T cells on atopic illnesses, we reviewed the literature on the physical roles and functions of various subsets of γδ T cells, including type 1 T helper (Th1)-like, type 2 T helper- (Th2)-like, and type 17 T helper (Th17)-like γδ T cells. Mouse Vγ1 T cells increase interleukin (IL)-4 levels and trigger B cell class switching and immunoglobulin E production. Meanwhile, mouse Vγ4 T cells and human CD8lowVδ1 T cells secrete interferon-γ and exert an anti-allergy effect similar to that of Th1 cells. Moreover, mouse Vγ6 T cells produce IL-17A, while Th17-like γδ T cells enhance neutrophil and eosinophil infiltration in the acute phase of inflammation, but exert anti-inflammatory effects in the chronic phase. Human Vγ9δ2 T cells may exhibit Th1- or Th2-like characteristics in response to certain types of stimulation. In addition, the microbiota can modulate epithelial γδ T cell survival through aryl hydrocarbon receptors; these γδ T cells play crucial roles in the repair of epithelial damage, antibacterial protection, antigen tolerance, and effects of dysbiosis on allergic diseases.