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Th1 and Th17 predominance in the enthesitis-related arthritis form of juvenile idiopathic arthritis
Journal of Rheumatology, 08/17/09

Mahendra A et al. – Study reports that in patients with enthesitis-related arthritis (ERA), peripheral blood Th1, Th2, Th17, and Treg cells were unchanged, but Th1 and Th17 cells were increased and Th2 cells were reduced in the synovial fluid (SF) compared to blood. Elevated IL-1β and IL-6 in SF may be responsible for increased Th17 cells.

Methods

An investigation of T cell phenotypes including Th1, Th2, Th17, and Treg with emphasis on Th17 and Treg, to differentiate cytokines in ERA form of JIA
Frequencies of Th1, Th2, Th17, and Treg cells were determined by flow cytometry in peripheral blood (PB) and SF from pts with ERA and healthy subjects
Levels of IL-1β, IL-6, IL-21, IL-23, and TGF-β, cytokines that influence Th17 lineage cells, were measured in paired plasma and SF by ELISA
Frequencies are expressed as percentages and cytokine levels as pg/ml

Results

No differences in blood samples in the frequency of Th1, Th2, Th17, and Treg cells between pts and controls
In paired samples, the median frequency of CD4+IFN-γ+ cells was higher in SF compared to PB
Frequency of CD4+IL-4+ cells was reduced in the SF compared to PB
There was no difference in the frequency of regulatory T cells
Pts receiving methotrexate had fewer Th2 cells
Childhood Health Assessment Questionnaire score had a negative association with the frequency of Treg
Median levels of IL-1β IL-6, and IL-17 were higher in SF than in plasma and levels of TGF-β were lower
Levels of IL-21 were similar in SF and plasma, whereas IL-23 was undetectable

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