25rhk048 10.3205/25rhk048 urn:nbn:de:0183-25rhk0487 Meeting Abstract Röhm Röhm Victor V

University Tübingen, Tübingen

author Henes Henes Jörg J

Center for Interdisciplinary Rheumatology, Immunology and Autoimmune diseases (INDIRA) and Department for Internal Medicine II (Hematology, Oncology, Clinical Immunology and Rheumatology), University Hospital Tübingen, Tübingen

author Pecher Pecher Ann-Christin AC

Center for Interdisciplinary Rheumatology, Immunology and Autoimmune diseases (INDIRA) and Department for Internal Medicine II (Hematology, Oncology, Clinical Immunology and Rheumatology), University Hospital Tübingen, Tübingen

author Klein Klein Reinhild R

Department for Internal Medicine II (Hematology, Oncology, Clinical Immunology and Rheumatology), University Hospital Tübingen, Tübingen

author German Medical Science GMS Publishing House

Düsseldorf

610 20250917 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0627 048 Deutsche Gesellschaft für Rheumatologie Deutsche Gesellschaft für Orthopädische Rheumatologie 53. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 39. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh) Deutscher Rheumatologiekongress 2025 Experimentelle & Translationale Rheumatologie Wiesbaden 20250917 20250920 ET.31 TextIntroduction: Systemic lupus erythematosus (SLE) poses unique and significant challenges during pregnancy, primarily due to its association with a high prevalence of maternal and fetal complications, including disease flares, preeclampsia, and adverse pregnancy outcomes . Despite advances in understanding autoimmune diseases, the precise interplay between the immunological adaptations necessary for maintaining pregnancy and the pathophysiological mechanisms of SLE that contribute to disease exacerbation remains poorly understood. This study intends to analyze the dynamics of T-helper (Th) subgroups in SLE patients across the course of pregnancy and the postpartum period, providing insights into their potential roles in modulating immune responses during gestation.Methods: A single-center prospective cohort study was carried out, including seven SLE patients treated at our clinic between January 2022 and April 2023. Peripheral blood samples were collected from seven SLE pregnancies during each trimester (T1, T2, T3) and the postpartum period (pp). Th1, Th2, Th17 and Treg were analyzed using flow cytometry, and statistical evaluation was performed using the Mann-Whitney test.Results: We identified a significant increase in proinflammatory activated Th1-cells during the third trimester compared to the second semester followed by a decrease postpartum. While activated Th2 cells exhibited similar fluctuations, these changes were not statistically significant. Activated Th2 and Treg display a decline from the first to the second trimester, however activated Th2 cells decrease postpartum while Treg increase till the postpartum period. Activated Th17 cells remained stable throughout pregnancy but decreased after delivery.Conclusion: Given that SLE is classified as a Th2-dominant condition and pregnancy is associated with a physiological increase in Th2 cell levels, this could potentially contribute to disease flares during gestation. However, the small size of this cohort limits definitive conclusions regarding the relationship between immunological shifts and disease activity. Further analysis in a larger sample is warranted.Disclosures: VR: Eli Lilly, JH: ABVVIE, Astra-Zeneca, GSK, Janssen, Novartis, UCB, RK: None declared, ACP: None declared.Figure 1 Moroni G Ponticelli C Pregnancy in women with systemic lupus erythematosus (SLE) 2016 Eur J Intern Med 7-12 Moroni G, Ponticelli C. Pregnancy in women with systemic lupus erythematosus (SLE). Eur J Intern Med. 2016 Jul;32:7-12. DOI: 10.1016/j.ejim.2016.04.005 http://dx.doi.org/10.1016/j.ejim.2016.04.005 0

1 1 Figure 1: T-helper subgroups in pregnant women with Systemic Lupus erythematosus. The Th1-cells increase significantly from the second to the third trimester and show a significant decrease 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.

1 0 0