Background: Systemic lupus erythematosus (SLE) poses unique challenges during pregnancy due to high prevalence of complications; yet the interaction between immunological adaptations in pregnancy and SLE pathophysiology resulting in disease flares has not been elucidated.

Objectives: This study aims to investigate T-helper (Th) subgroups in SLE patients throughout pregnancy and the postpartum period to evaluate their role during gestation.

Methods: A monocentric prospective cohort study was conducted involving SLE patients in our clinic from January 2022 to April 2023. Peripheral blood samples of 7 SLE pregnancies were collected at every trimester and postpartum with flow cytometry analysis of Th-cells. Statistical analysis was performed using Mann-Whitney test.

Results: We observed a significant increase in proinflammatory Th1-cells during the third trimester compared to the second semester and decline in the postpartum period. Th2-cells showed these fluctuations as well, but not significantly. T-regulatory cells (Treg) showed signs of decline from the first to the second trimester and a rise till the postpartum period. The proinflammatory Th17-cells stayed stable during pregnancy and decline postpartum.

Conclusion: As SLE is considered a Th2-mediated disease and we notice a physiological rise of Th2-cell levels during pregnancy, this could possibly be associated with SLE flares during pregnancy. However, this cohort is yet too small to make conclusive statements regarding the correlation between immunologic changes and disease activity and therefore this analysis will be continued in the future.

Figure 1.

T-helper subgroups in pregnant women with Systemic Lupus Erythematodes. The Th1-cells rise significantly from the second to the third trimester and decline significantly postpartum. (A) Activated Th1-cells. (B) Activated Th2-cells. (C) T-regulatory cells. (D) Activated Th17-cells. Statistically significant results *p = < 0,05. Abbreviations: HLA-DR, Human Leukocyte Antigen – DR isotype; Th, T-helper cell; Treg, T-regulatory cell; T, Trimester; pp, postpartum.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: Victor Röhm Eli Lilly, Jörg Henes ABVVIE, Astra-Zeneca, GSK, Janssen, Novartis, UCB, Reinhild Klein: None declared, Ann-Christin Pecher: None declared.