title: Regulatory Effect of Iguratimod on the Balance of Th Subsets and Inhibition of Inflammatory Cytokines in Patients with Rheumatoid Arthritis.
abstract: OBJECTIVE
  To expand upon the role of iguratimod (T-614) in the treatment of rheumatoid arthritis (RA), we investigated whether the Th1, Th17, follicular helper T cells (Tfh), and regulatory T cells (Treg) imbalance could be reversed by iguratimod and the clinical implications of this reversal.
  
  
  METHODS
  In this trial, 74 patients were randomized into iguratimod-treated (group A) and control (broup B) group for a 24-week treatment period. In the subsequent 28 weeks, both groups were given iguratimod. Frequencies of Th1, Th17, Tfh, and Treg were quantified using flow cytometry, and serum cytokines were detected by enzyme-linked immunosorbent assay. mRNA expression of cytokines and transcriptional factor were quantified by RT-PCR. The composite Disease Activity Score, erythrocyte sedimentation rate, and C-reactive protein were assessed at each visit.
  
  
  RESULTS
  The clinical scores demonstrated effective suppression of disease after treatment with iguratimod. In addition, iguratimod downregulated Th1, Th17-type response and upregulated Treg. Furthermore, the levels of Th1, Th17, and Tfh associated inflammatory cytokines and transcription factors were reduced after treatment with iguratimod, while the levels of Treg associated cytokines and transcription factors were increased.
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Guanghua Integrative Medicine Hospital, Shanghai 200052, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhu
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Jinglve
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Hongli
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Yutong
authors.initials: Y
authors.lastname: Miao
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Feiyan
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Yebin
authors.initials: Y
authors.lastname: Xi
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Xiaoyin
authors.initials: X
authors.lastname: Niu
authors.affiliation: Guanghua Integrative Medicine Hospital, Shanghai 200052, China.
authors.forename: Dongyi
authors.initials: D
authors.lastname: He
authors.affiliation: Department of Immunology and Microbiology, Shanghai JiaoTong University School of Medicine, Shanghai Institute of Immunology, Shanghai 200025, China.
authors.forename: Guangjie
authors.initials: G
authors.lastname: Chen
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D002867:Chromones / Q000627:therapeutic use*; D016207:Cytokines / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013449:Sulfonamides / Q000627:therapeutic use*; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects; D018417:Th1 Cells / Q000187:drug effects*; D058504:Th17 Cells / Q000187:drug effects*
chemical_list: D002867:Chromones; D016207:Cytokines; D013449:Sulfonamides; C519076:iguratimod