Decreased Th17 and Th1 cells in the peripheral blood of patients with early non-radiographic axial spondyloarthritis: a marker of disease activity in HLA-B27⁺ patients.
OBJECTIVE
To examine the frequency and phenotype of Th17 cells in the peripheral blood of patients with early non-radiographic axial SpA (early nrSpA).


METHODS
CD4(+) T cells were isolated from the peripheral blood of 30 early nrSpA patients, 11 AS patients and 41 age- and sex-matched healthy controls by Ficoll-Hypaque gradient and magnetic negative selection. After polyclonal stimulation, the frequency of Th17 and Th1 cells and of cells producing TNF-α or IL-10 was determined by cytometry and concentrations of IL-17, IL-22, IFN-γ, TNF-α, IL-10 and IL-4 were measured by ELISA.


RESULTS
Early nrSpA but not AS patients demonstrated a significantly lower percentage of circulating Th17, Th1 and Th17/Th1 cells, together with lower CD4-derived IL-17 and IFN-γ secretion, as compared with controls. In contrast, the percentage of circulating cells producing IL-10 or TNF-α, and the secretion of CD4-derived IL-10, TNF-α, IL-22 and IL-4 in early nrSpA were not different from controls. All Th17 cells were CD45RO(+)CD45RA(-) and CCR6(+). The frequency of circulating Th17, Th1 and Th17/Th1 was negatively correlated with BASDAI, BASFI, ASDAS-CRP, ASDAS-ESR, AS quality of life (ASQOL) and patient's global assessment in HLA-B27(+) but not in HLA-B27(-) early nrSpA patients. A positive correlation between circulating Th17 cells and BASDAI was observed in AS.


CONCLUSIONS
A decreased percentage of Th17, Th1 and Th17/Th1 cells is apparent in peripheral blood CD4(+) T cells from early nrSpA. Th17, Th1 and Th17/Th1 cell numbers are related to disease activity indices in HLA-B27(+), but not in HLA-B27(-), early nrSpA patients.
Department of Rheumatology, Hospital La Paz, Madrid, Spain.
María-Belén
MB
Bautista-Caro
Irene
I
Arroyo-Villa
Concepción
C
Castillo-Gallego
Eugenio
E
de Miguel
Diana
D
Peiteado
Amaya
A
Puig-Kröger
Emilio
E
Martín-Mola
María-Eugenia
ME
Miranda-Carús
D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D015796:HLA-B27 Antigen / Q000276:immunology; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011788:Quality of Life; D012720:Severity of Illness Index; D025241:Spondylarthritis / Q000097:blood*; D018417:Th1 Cells / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D055815:Young Adult
D015415:Biomarkers; D016207:Cytokines; D015796:HLA-B27 Antigen; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10