The TH17/Treg Imbalance in Rheumatoid Arthritis and Relation to Disease Activity
|Taghrid Gaafar1*, Reem Farid1, Hala Raafat2, Faten Bayoumi3,4, Botros Gerges3 and Dina Rasheed1|
|1Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt|
|2Department of Rheumatology, Faculty of Medicine, Cairo University, Cairo, Egypt|
|3Department of Immunogenetics, National Research Centre, Giza, Egypt|
|4Head of Microbiology and Immunology Department, College of Pharmacy, MSA University, Egypt|
|Corresponding Author :||Taghrid Gaafar
MD, Clinical and Chemical Pathology Department (Stem cell research unit)
Faculty of Medicine, Cairo University, Egypt
E-mail: [email protected]
|Received: September 03, 2015; Accepted: December 28, 2015; Published: December 31, 2015|
|Citation: Gaafar T, Farid R, Raafat H, Bayoumi F, Gerges B, et al. (2015) The TH17/Treg Imbalance in Rheumatoid Arthritis and Relation to Disease Activity. J Clin Cell Immunol 6:381. doi:10.4172/2155-9899.1000381|
|Copyright: © 2015 Gaafar T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Objectives: T regulatory cells (Treg) and proinflammatory TH17 cells are newly identified T lymphocyte subsets, which have significant effects on autoimmunity and inflammation. Tregs play key role in the maintenance of self-tolerance. TH17/Treg disturbed balance has been reported to contribute to several autoimmune diseases.
Our aim was to assess the Treg/TH17 pattern and TH17 related cytokines, in peripheral blood of Egyptian rheumatoid arthritis patients, and their relation to disease activity score (DAS). Analyzing IL17A and IL23 as indicators of TH17 function, was to study the effect of TH17 in RA.
Methods: 100 Egyptian rheumatoid arthritis patients, divided into Group I (14), Group II (48), Group III (38), with low <3.2, moderate 3.2 to <5.1 and high >5.1, activity DAS score respectively; and 50 healthy age and sex matched controls were enrolled. Peripheral blood TH17 and Treg (CD4+CD25+Foxp3+) frequencies were analyzed by flowcytometry, and the serum levels of interleukins (IL17A), (IL23) were determined by ELISA.
Results: Active RA patients (groups II and III) revealed an obvious increase in peripheral TH17 frequencies, and levels of TH17-related cytokines, and a significant decrease in Treg (CD4+CD25+Foxp3+) frequencies in group III, when compared to healthy controls. TH17/Treg ratios were positively correlated with serum concentrations of IL17A and IL23 cytokines. Frequencies and levels showed statistical significant correlation with DAS scoring.
Conclusions: Our study indicated that TH17/Treg balance was disturbed in peripheral blood of RA patients, leading to an increase of proinflammatory cytokines, correlating with DAS, and suggesting an important role in the development of RA.