Correlation between Th17 and nTreg cell frequencies and the stages of progression in chronic hepatitis B

Abstract

Several studies have suggested that the balance of T helper 17 (Th17) and natural regulatory T (nTreg) cells in the Th17‑mediated immune response are critical in the pathogenesis of viral hepatitis. The aim of the present study was to examine the role of circulating Th17 and nTreg cells in the disease progression of hepatitis B virus (HBV) infection. A total of 40 patients with chronic HBV (CHB), 27 patients with HBV‑associated cirrhosis, 20 patients with HBV‑associated liver failure and 20 healthy controls were enrolled in the present study. The frequencies of Th17 and nTreg cells in the peripheral blood were examined using flow cytometry. Th17‑associated serum cytokine levels were measured using an enzyme‑linked immunosorbent assay. The results revealed a significantly higher frequency of circulating Th17 cells in the patients with CHB, cirrhosis and liver failure compared, with the normal controls, particularly in the patients with liver failure. The same trend was observed in the serum levels of interleukin (IL)‑17. The frequency of Th17 cells and the serum levels of IL‑17 were positively correlated with the levels of alanine aminotransferase and the prothrombin times. There was a significantly higher frequency of circulating nTreg cells in the patients with CHB, compared with the normal controls. The nTreg cell frequencies were significantly and positively correlated with plasma HBV DNA load, and were negatively correlated with Th17 frequencies in the cohort of patients with HBV. Taken together, the results suggested that Th17 cell‑mediated inflammation is associated with progression from CHB to cirrhosis, and to liver failure. Peripheral Th17 cell frequency and serum levels of IL‑17 may assisting in predicting the severity of liver damage and fibrosis.

The balance of type 1 and type 2 immune responses in the contexts of hepatitis B infection and hepatitis D infection

“…5 Previous works demonstrate increased IL-17 expression and circulating type 17 helper T cells in HBV-linked and HCV-linked liver fibrosis. [38][39][40][41] Our findings reinforce these works (Fig. 2).…”

Secukinumab in moderate-to-severe plaque psoriasis: a multi-center, retrospective, real-life study up to 52 weeks observation

“…To our knowledge, only five patients with HBV infection have been treated so far with secukinumab and, similarly to our case, HBV reactivation or elevation in liver enzymes was not found [24,25]. In this regard, several studies have shown that Th17 cells play a critical role in the pathogenesis of viral hepatitis, with serum levels of IL-17 being able to predict the severity of liver damage and fibrosis [26]. For this reason, inhibitors of IL-17 as secukinumab could have a protective role in the progression of liver injury and may be preferred in psoriatic patients with HBV or HCV infection.…”

HBV promotes the recruitment of IL‐17 secreting T cells via chemokines CCL22 and CCL17

“…These results are consistent with all previous data indicating the high proportion of Th17 cells among PBMCs of patients with HBV infection 24 . Furthermore, Th17 might also be linked to continuous HBV infection 25 . The Treg/Th17 balance, the Th17/IL‐17 axis, IL22 and IL23, etc., have been considered the key prognostic and immunopathological elements in patients with HBV.…”