Double-negative T cells (DNTs) were significantly elevated in autoimmune diseases and were thought to play an important role in inflammation. DNT cells were initially identified and characterized in lpr and gld mice in which lymphoproliferative syndrome developed due to impaired Fas-mediated apoptosis. In the meantime, DNTs gathered in large numbers. Later on, expanded DNT cells were observed in patients with autoimmune diseases, including systemic lupus erythematosus and Sjogren’s syndrome. The expansion of DNTs in various autoimmune diseases and the presence of DNTs at sites of inflammatory conditions strongly suggest their critical roles in inflammation. The purpose of this study was to explore its important role in children with systemic lupus erythematosus (cSLE). The cSLE is an autoimmune mediated inflammatory disease, which can involve multiple organs. The most important immune characteristic is the production of a large number of autoantibodies. Previous study has found that DNTs were elevated in cSLE. However, this study did not further explore the relevance between DNTs and clinical manifestations, laboratory, and cell subsets of patients with cSLE.

The DNTs, T and B cell subsets of peripheral blood were detected by flow cytometry in 78 patients, and clinical and laboratory data of cSLE patients were collected to analyze the correlation between DNTs and the above indexes. The changes of DNTs after glucocorticoids were detected, and the effects of different doses of glucocorticoids on DNTs were analyzed.

DNTs was significantly increased in peripheral blood of cSLE patients. DNTs were associated with SLE disease severity and organ involvement, as well as with the production of autoantibodies, Naive B cell and plasmablast cells. The level of DNTs increased after low-dose glucocorticoid treatment, but the proportion of DNTs gradually decreased with the increase of glucocorticoid dose. DNTs significantly decreased from the 4th day of glucocorticoid pluse therapy.

DNTs was positively correlated with disease severity in cSLE patients, and the effect of glucocorticoid dose on DNTs was different.