CD28 and systemic lupus erythematosus: Expansion of TDEM CD8+ T cells (CD45RA+CCR7-CD27-CD28-) producing high levels of proinflammatory cytokines and cytotoxic activity have been indeed reported in SLE with high disease activity and damage indexes (49) and have been shown to be associated with a higher risk of long-term kidney graft dysfunction (50, 51).