Background Spondyloarthrit (SpA) is a chronic autoimmune disease and is associated with immunological function disorder. Previous studies have observed that increased number of T17 cells and decreased number of Regulatory T (Treg) cell in patients with S [1,2]. However, the current therapy for SpA, focusedon NSAID, biological agents and glucocorticoid, can't correct the imbalance of Th17 and Treg cells. Metformin has been demonstrated a reducing effect on Th17 cells but an increasing effect on Treg cells, regulating the Thl7/Treg ratio .
Objectives The study is to explore the effect of metformin therapy on the balance of Th17 and Treg cells in patients with SpA.
Methods SpA patients (n=27) (from August 1st to November 30th in 2016, both outpatients and inpatients in our department, according to American-European Consensus Group criteria for SpA), who were given metformin (750mg/day for 6 weeks). Laboratory indicators were compared before and after metformin treatment.
Results The number of Treg cells [25.37 (18.31,45.78) vs.34.43 (25.91,50.31), P=0.015] significantly increased after the treatment. At the same time, there was a significantly decrease in the ratio of Th17/Treg cells [0.26 (0.15,0.48) vs. 0.22 (0.1,0.33), P+0.037]. Besides, Th17 cells were also decreased [7.85 (4.95,10.65) vs. 6.42 (3.7,10.63)].
Conclusions Metformin can restore and maintain the balance of Th17 and Treg cells in the patients with SpA. And it may be a potential therapy for SpA.
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Shen H, Goodall JC, Hill Gaston JS. Frequency and phenotype of peripheral blood Th17 cells in ankylosing spondylitis and rheumatoid arthritis.Arthritis Rheum. 2009;60:1647–56.
Son HJ, Lee J. Metformin attenuates experimental autoimmune arthritis through reciprocal regulation of Th17/Treg balance and osteoclastogenesis. Mediators Inflamm.2014,2014:973986.
Disclosure of Interest None declared
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