Reduction of bcl-2 in T cells during immunosuppressive therapy in patientswith severe juvenile onset systemic lupus erythematosus

Overexpression of bcl-2 protein has been observed in the cytoplasm of T lym phocytes from adults with systemic lupus erythematosus (SLE), The aims of o ur study were to investigate the distribution of bcl-2 in T and B cells fro m patients affected with juvenile onset SLE (JSLE) and to monitor the modif ication of bcl-2 expression under immunosuppressive therapy. Thirty-two JSL E patients entered the study; 45 pathological and 16 healthy subjects were studied as controls. In SLE patients the disease activity was assessed usin g SLE disease activity index score. Bcl-2 expression was evaluated by cytof luorimetry. PCR analysis of t(14,18) translocation was performed from genom ic DNA isolated from peripheral blood mononuclear cells. An increased bcl-2 expression both on cytoplasm and on cell surface of circulating T lymphocy tes in JSLE patients with active disease was found. A variation, under phar macological treatment, of protein expression during the course of the disea se was observed. PCR analyses demonstrated that 14, 18 translocation was no t associated with bcl-2 overexpression. Our data show a strong correlation between bcl-2 protein expression and disease activity and suggest an altera tion of apoptotic regulation in JSLE patients. (C) 1999 Academic Press.