Objective Rheumatoid arthritis (RA) is a typical, progressive autoimmune disease. Its occurrence and development are associated with dysregulation of T and B cell numbers. However, the specific immune characteristics of different RA courses remain incompletely defined. Here, we describe the peripheral blood lymphocyte subsets, particularly CD4 + T subsets, of different RA courses with a focus on early RA (Ea-RA). Methods In all, 131 patients with Ea-RA, 117 with advanced RA (Ad-RA), and 109 with treated RA (Tr-RA) were enrolled. We collected general clinical data. Whole blood samples obtained from the patients and 97 healthy controls (HCs) were analysed via flow cytometry. Results Decreased absolute NK cell numbers and increased CD4/CD8 T cell ratios were observed in different RA groups, including Ea-RA, compared to healthy controls. In Ea-RA patients, the Th17 and Treg cell numbers were similar to those in HCs. We performed k-means clustering based on the profiles of Th17 and Treg cells for patients with multi-stage of RA. We identified three patient types: type A characterised by relatively low Treg and Th17 cell numbers, type B with moderate levels of Treg cells and levels of Th17 cells similar to that of type C patients, and type C with high levels of Treg cells and levels of Th17 cells similar to that of type B patients. Conclusion The immune characteristics of Ea-RA patients differ from those of HCs; an immune system disorder is apparent although no differences in Th17 and Treg levels were evident between Ea-RA patients and HCs. We found distributional heterogeneities of Th17 and Treg cells in patients with multi-stage of RA. Stratified management based on such heterogeneity may serve as a useful novel immunotherapy allowing of early intervention.

Objective: In patients with dermatomyositis/polymyositis (DM/PM), especially DM patients with positive antibodies against melanoma differentiation-associated protein 5 (MDA5), the prognosis is very poor, acute progressive pulmonary interstitial disease is likely to occur, and the mortality rate is very high, while serum soluble interleukin-2 receptor (sIL-2R) is often used as a marker to assess T cell activation, it is still poorly understood. The aim of this study was to investigate the relationship between sIL-2R levels and disease activity, absolute number of peripheral blood lymphocyte subsets and related cytokines in DM patients. Method: Sixty patients with DM (32 patients with inactive DM and 28 patients with active DM) were enrolled in this study and divided into inactive and active groups according to the Myositis Disease Activity Visual Analogue Scale (MYOACT), and the absolute numbers of peripheral lymphocyte subsets and CD4 + T cell subsets were measured by flow cytometry in each group, and serum cytokine levels were measured by flow cytometry bead array. Results: Serum sIL-2R levels were positively correlated with independent visual analogue scale (VAS) in DM patients (p < 0.001), and the ratio of Th17/Treg cells was significantly higher in DM patients compared with the healthy group (P < 0.01), and there was a correlation between serum sIL-2 levels and Th17/Treg ratio. Multivariate logistic regression revealed that serum sIL-2R levels were an independent factor affecting disease activity. Serum IL-6 and IFN-γ levels were also increased in the active group compared with the inactive group (p = 0.011 and p = 0.034, respectively). In addition, receiver operating characteristic (ROC) curves showed that serum sIL-2R levels contributed to the discrimination of disease activity in DM patients, with an area under the ROC curve (AUC) of 0.757 (95% CI 0.630 – 0.884, P = 0.001). Conclusion：In DM patients, serum sIL-2R levels are not only closely related to disease activity, but also involved in their Th17/Treg immune imbalance, which is an effective indicator for evaluating DM disease activity.