Decreased Th1 Cells and Increased Th2 Cells In Peripheral Blood Are Associated with Idiopathic Inflammatory Myopathies Patients With Interstitial Lung Disease

Abstract

Objective. Interstitial lung disease (ILD) is a common and highly fatal manifestation of idiopathic inflammatory myopathies (IIMs). T helper (Th) cells play important roles in the initiation of ILD. Here, we investigated the clinical significance of peripheral blood Th cells in IIMs-ILD patients. Methods. 11 healthy controls (HC) and 57 patients diagnosed with IIMs were included, including 30 with ILD (IIMs-ILD) and 23 without ILD (IIMs-non-ILD). Circulating Th1, Th2, Th17, and Treg cells were examined by flow cytometry, and their correlation with clinical and laboratory findings was analyzed by Spearman’s correlation and logistic regression. Results. The proportion of Th1 cells decreased and Th2 cells increased in IIMs-ILD compared with IIMs-non-ILD patients (median (quartile): 2.99 (1.59–5.39) vs. 6.91 (3.48–10.04), p < 0.001; 2.67 (1.79–4.67) vs. 1.62 (0.85–2.66), p = 0.006), and correlated with disease activity. Th1 cells proportion decreased in anti-MDA5 antibodies positive patients, while the Th2 cells proportion increased in patients with nonspecific interstitial pneumonia, compared with IIMs-non-ILD patients(2.66(1.06–4.35) vs. 6.91 (3.48–10.04), p = 0.002; 3.09(2.03–5.72) vs. 1.62 (0.85–2.66), p = 0.016). Th1 proportion decreased, Th2 proportion increased, positivity for ARS or anti-Ro52 antibodies (OR = 0.7122; OR = 1.679; OR = 9.188 and OR = 6.161, respectively) were associated with the occurrence of ILD in IIMs patients. Conclusion. A decreased Th1 cell percentage and an elevated Th2 cells percentage in peripheral blood may be the pathogenesis of ILD in IIMs patients and have different effects on different serological and imaging subtypes.