Background Despite the presence of an increase in immunoregulatory cells in rheumatoid arthritis (RA), chronic inflammation persists and activity recurs. This finding has been intriguing rheumatologists and immunologists trying to justify the presence of activity daring this quarterback of cells usually aiming to fight inflammatory process. Namely the forkhead box P3 (FoxP3) transcription factor, essential for T regulatory cells (T regs) development and function is now considered their most specific marker denoting FoxP3+ cells as suppressors whereas FoxP3- effectors.
Objectives To clarify the subsets distribution of peripheral blood (PB) CD4+CD25+ T regulatory cells (T regs) according to FoxP3 expression in RA (both in remission & activity) for a better understanding of RA pathogenesis highlighting future therapeutic targets.
Methods In our observational cross-sectional study PB T regs from 40 RA patients & 20 age and sex matched healthy controls (HC) were characterized and quantified by flow cytometry. Disease activity was evaluated by DAS28. Patients were divided into 2 equal groups: active RA group (ARA) & remission RA group (RRA). All patients were on methotrexate MTX and folic acid.
Results A significantly higher T regs subsets numbers were found on comparing RRA, ARA patients & HC as shown in table 1
Conclusions CD4+CD25+FoxP3+ & CD4+CD25+FoxP3- are both increased in RA but it is their balance that is more important; the abundance of Foxp3- cells gave the effector function the upper hand over the suppressive function represented in Foxp3+ cells. This imbalance is related to the presence of RA & to its activity. Restoring this imbalance by future targeting therapeutics might be of great benefit in RA patients.
Beyer M & Schultze JL: Regulatory T cells in cancer. Blood. 2006; 108:804–811.
Wan YY & Flavell RA: Regulatory T-cell functions are subverted and converted owing to attenuated Foxp3 expression. Nature. 2007;445:766–770.
Han GM, O’Neil-Andersen NJ, Zurier RB & Lawrence DA:CD4+CD25high T cell numbers are enriched in the peripheral blood of patients with rheumatoid arthritis. CellImmunol. 2008; 253(1-2):92-101.
Disclosure of Interest None Declared
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