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Immunologic Parameters for Disease Activity in Rheumatoid Arthritis
E Riyadh Mohsen1, N H Ali1, H A Aldaoseri1
1College of Medicine, University of Basrah, Basrah, Iraq.
Archives of Razi Institute
|January 31, 2022
Summary
This study found that a lower frequency of regulatory T cells (Treg) and Forkhead box protein 3 (Foxp3) cells correlates with higher rheumatoid arthritis (RA) disease activity. Combined therapy with methotrexate (MTX) and anti-tumor necrosis factor (TNF)-α effectively reduced disease activity by reverting Th17 cell expansion.
Area of Science:
- Immunology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation.
- T helper 17 (Th17) cells and regulatory T cells (Treg) play crucial roles in RA pathogenesis.
- The balance between Th17 and Treg cells is critical in maintaining immune homeostasis.
Purpose of the Study:
- To investigate the correlation between disease activity in RA patients treated with anti-tumor necrosis factor (TNF)-α therapy and the ratio of Th17 cells to regulatory T cells (Treg) expressing Forkhead box protein 3 (Foxp3).
- To evaluate the impact of different therapeutic regimens, including methotrexate (MTX) and anti-TNF agents, on this Th17/Treg/Foxp3 ratio and RA disease activity.
Main Methods:
- A case-control study involving 84 RA patients and 13 healthy controls.
- Patients were categorized into groups receiving methotrexate (MTX) monotherapy, anti-TNF monotherapy, combined MTX and anti-TNF therapy, or no medication.
- Flow cytometry was used to measure Th17 and Treg/Foxp3 cell populations, while the Disease Activity Score 28 (DAS-28) assessed RA disease activity.
Main Results:
- Disease activity score (DAS-28) in RA patients significantly correlated with the Th17/Treg/Foxp3 ratio and Th17 cell count.
- A lower frequency of Treg/Foxp3 cells was associated with a higher DAS-28 score, indicating increased disease activity.
- Combined MTX and anti-TNF therapy demonstrated lower disease activity compared to other treatment groups, suggesting a synergistic effect and reversion of Th17 cell expansion.
Conclusions:
- The Th17/Treg/Foxp3 ratio is a significant indicator of disease activity in rheumatoid arthritis patients undergoing anti-TNF therapy.
- Combined therapy with MTX and anti-TNF agents is effective in managing RA, likely by modulating the Th17/Treg balance and reducing Th17 cell proliferation.
- This study highlights the therapeutic potential of targeting Th17/Treg pathways in RA management.
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