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Abstract
Objectives: We investigated the characteristics of circulating T-helper (Th) cells and CD4+ regulatory T cells (Tregs) in polyarteritis nodosa (PAN).
Methods: Peripheral blood samples were obtained from 14 patients with PAN. Nine patients having granulomatosis with polyangiitis (GPA) and 11 healthy individuals (HC) were enrolled as controls. Th cells and Tregs were analyzed by flow cytometry. Suppression assay of Tregs was simultaneously performed by evaluating the proliferation of conventional CD4+ T cells cocultured with Tregs.
Results: The frequencies of Th cells were significantly higher in PAN than in HC. In comparison with GPA, the expression of Th1 cells was higher but that of Th17 cells was lower. Additionally, significant increase in Tregs was observed in PAN, which was correlated with the expression of Th1 cells; however, defects in suppressive ability and CTLA-4 expression were observed. The Th1-cell frequency was significantly decreased after immunosuppressive therapy in PAN; however, there were no improvements in other phenotypes or in Treg function.
Conclusion: T-helper cell expansion and Treg dysfunction are thought to be associated with the pathogenesis of PAN. Th1 cells show a response to immunosuppressive therapy; however, the persistent immune abnormalities may interfere with complete recovery in patients with PAN.
Acknowledgments
We thank all the members of the Department of Medicine (Neurology and Rheumatology), Shinshu University Hospital for treating the patients.
Conflict of interest
The authors declare they have no financial or personal conflict of interest to this manuscript.
Funding information
This study was supported by a grant from KISSEI COMTEC Co., LTD., AIBAWORKS Co., LTD., and the Ministry of Health, Labour and Welfare of Japan.