title: Persistent improper upregulation of Th17 and TReg cells in patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. A break in the balance between Th17 and TReg cells has been reported as an important factor in the development of autoimmune diseases. This study aimed to analyze peripheral Th17 and TReg cell levels in patients with JIA.
  
  
  METHODS
  The balance of Th17 and TReg cells among active and inactive JIA patients and normal control subjects were compared. Human peripheral blood mononuclear cells were isolated from the patients and controls. Surface and intracellular staining for CD4, CD25, Foxp3, IL-17, Th17, and TReg were analyzed.
  
  
  RESULTS
  Twenty-eight JIA patients, including 12 with active JIA and 16 with inactive JIA, and 20 health controls were analyzed. Patients with active JIA had higher Th17 (1.85 ± 1.15 vs. 1.05 ± 0.72, p = 0.008) and TReg cells (1.1 ± 0.8 vs. 0.6 ± 0.7, p = 0.04) levels than those with inactive JIA. Among active JIA patients, remission days were highly correlated with the CD4(+)IL17A(+) T cell percentage, 276.5 ± 137.40 days (range, 130 ∼ 525 days), p < 0.01. There were no differences in Th17/TReg percentage between JIA patients and controls in the peripheral blood.
  
  
  CONCLUSIONS
  Th17 and TReg cell levels are elevated in patients with active JIA and there is no Th17/TReg imbalance. The higher Th17 level predicted longer period to reach disease inactive stage. Improper Th17 up-regulation might contribute to JIA activation.
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Shun-An
authors.initials: SA
authors.lastname: Wu
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kuo-Wei
authors.initials: KW
authors.lastname: Yeh
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen-I
authors.initials: WI
authors.lastname: Lee
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tsung-Chieh
authors.initials: TC
authors.lastname: Yao
authors.affiliation: Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan. Electronic address: long@adm.cgmh.org.tw.
authors.forename: Jing-Long
authors.initials: JL
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D002648:Child; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D020381:Interleukin-17 / Q000378:metabolism; D008297:Male; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*; D015854:Up-Regulation / Q000276:immunology; D055815:Young Adult
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C508717:IL17A protein, human; D020381:Interleukin-17
keywords: Juvenile idiopathic arthritis; T helper cells/Th17; regulatory T cells/T(Reg)