Vitamin A improve Th17 and Treg regulation in systemic lupus erythematosus

Abstract

The aim of this study was to determine the role of vitamin A in modulating T helper 17 (Th17) and regulatory T cell (Treg) balance in systemic lupus erythematosus (SLE) patients. Sixty-two female SLE patients and sixty-two female controls were measured for vitamin A levels from serum by enzyme-linked immunosorbent assay (ELISA) and percentages of Th17 and Treg from peripheral blood mononuclear cells (PBMC) by flow cytometry. We also performed an in vitro study to evaluate the effects of retinoic acid treatment (0, 0.1, 0.2, and 0.3 μg/ml) in modulating Th17/Treg balance in CD4(+) T cell culture from hypovitaminosis A SLE patients. Th17 and Treg percentages from cell cultures were measured by flow cytometry. Vitamin A levels in the SLE patients were lower compared to those in the healthy control (46.9 ± 43.4 vs. 75.6 ± 73.1 ng/ml, p = 0.015). Vitamin A levels also had a negative correlation to Th17 percentages in the SLE patients (p = 0.000, R = -0.642). Th17 percentages in the hypovitaminosis A SLE patients were higher compared to those SLE patients with normal vitamin A levels (10.9 ± 5.3 vs. 2.9 ± 2.2 %, p = 0.000). Treatment of 0.3 μg/ml of retinoic acid could increase Treg differentiation (33.9 ± 1.6 vs. 21.8 ± 1.1 %, p = 0.000) and decrease Th17 differentiation (27.2 ± 2.5 vs. 37.4 ± 1.3 %, p = 0.000). In conclusion, vitamin A has important roles in modulating Th17/Treg balance in the SLE patients shown by the significant decrease of vitamin A levels in the SLE patients which negatively correlate with Th17 population, and treatment of retinoic acid could decrease Th17 and increase Treg percentages in CD4(+) T cells cultures.

Altered frequency of Th17 and Treg cells in new‐onset systemic lupus erythematosus patients

“…Significant decrease, or no alterationsof Treg cells in active SLE was reported by different investigators. However, increased Treg cells have also been described, concordant with our result. Why there are conflicting data on the quantity of Treg cells in SLE?…”

Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review

“…Daily intake of 100,000 U of vitamin A produced enhanced antibody-dependent cellular cytotoxicity, natural killer cell and IL-2 activities in patients with SLE ( 104 ). In a case-controlled study with Indonesian patients with SLE ( n = 62), vitamin A modulated T-helper type (Th17), and Treg cell balance ( 105 ).…”

Recent findings on the Coronavirus disease 2019 (COVID-19); immunopathogenesis and immunotherapeutics

“…In addition, vitamin A stimulates the production of type I interferon, thereby, exerting antiviral activities [166] . In addition, vitamin A confers a therapeutic potential in autoimmunity by modulating the Th17/Treg balance [167] , [168] . Taking together, vitamin A might be beneficial in COVID-19 patients by modulating immune system toward an anti-inflammatory setting during remission phase of the disease and by stimulation of anti-viral state.…”