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Effect of systemic steroid therapy in Graves' orbitopathy on regulatory T cells and Th17/Treg ratio

M Siomkajło1, Ł Mizera2, D Szymczak3

  • 1Department of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, L. Pasteur 4, 50-367, Wroclaw, Poland. martasiomkajlo@10g.pl.

Journal of Endocrinological Investigation
|April 18, 2021
PubMed
Abstract

Insights

Systemic steroid therapy for Graves' orbitopathy did not improve outcomes by altering regulatory T lymphocytes (Tregs) or T helper 17 lymphocytes (Th17). The observed decrease in Tregs was a non-specific steroid effect, not linked to clinical improvement.

Area of Science:

  • Immunology
  • Endocrinology
  • Ophthalmology

Background:

  • Graves' orbitopathy is an autoimmune condition affecting the eyes.
  • Glucocorticoids are a common treatment, but their mechanism is not fully understood.
  • Regulatory T lymphocytes (Tregs) and T helper 17 lymphocytes (Th17) play roles in immune regulation.

Purpose of the Study:

  • To investigate if systemic steroid therapy for Graves' orbitopathy impacts Treg and Th17 cell levels.
  • To determine if changes in Treg and Th17 cells correlate with treatment effectiveness.

Main Methods:

  • 32 patients with active Graves' orbitopathy received methylprednisolone pulses.
  • Peripheral blood Treg and Th17 levels were measured via flow cytometry.
  • Disease activity, severity, and treatment response were assessed using clinical scores and criteria.

Main Results:

  • Methylprednisolone improved disease activity but altered the Th17/Treg balance.
  • The percentage of Tregs decreased, while Th17 cell numbers remained stable.
  • No correlation was found between the Treg/Th17 ratio and disease activity, severity, or treatment outcomes.

Conclusions:

  • Steroid therapy's benefits in Graves' orbitopathy are not mediated by peripheral Treg/Th17 changes.
  • The reduction in Treg percentage is likely a non-specific steroid effect.
  • Peripheral Treg and Th17 levels do not predict clinical outcomes in this context.
Keywords:
FOXP3GlucocorticosteroidsOrbitopathyRORγtTh17Treg

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