Anti‐tumor necrosis factor treatment increases both the Th17 and Th22 T helper subsets in spondyloarthritis

Abstract

The aim was to examine anti‐tumor necrosis factor α (anti‐TNFα) therapy influence changes on Th17 and Th22 cells in patients with spondyloarthritis (SpA), and its correlation with changes in clinical and magnetic resonance imaging (MRI) activity and chronicity scores. The Th17 and Th22 cells were assessed at baseline, after 12 and 52 weeks of anti‐TNFα therapy by flow cytometry (ClinicalTrials.gov NCT4682724). The percentages of both Th17 and Th22 cells were increased by 70% at baseline compared with healthy controls (both p < 0.01). During treatment, these two subsets increased further to be 170% (Th17) and 123% (Th22) above levels in healthy controls (both p < 0.01). The same subsets decrease their expression of IL‐23R significantly during the observation period (p < 0.05). High levels of Th17 and Th22 cells at baseline were associated with the degree of chronic changes in the sacroiliac joints on MRI and a good clinical response to anti‐TNFα treatment after one year. Plasma levels were not associated with clinical changes. Th17 cells, and Th22 subsets, increased during one year of anti‐TNF‐α therapy in SpA, regardless of their clinical improvement. This supports that both the Th17 and Th22 subsets could be involved in the progression in SpA.

Novel approaches to develop biomarkers predicting treatment responses to TNF-blockers

“…In the same study, the authors found that also serum levels of IL-6, IL-17 and IL-23 significantly decreased only in responders [95]. On the contrary, an increase in IL-17+ and in IL-22+ cells after adalimumab treatment was reported by Andersen et al in 30 SpA patients [96].…”

“…An interplay of several innate and adaptive immune cell populations may be involved in SpA pathogenesis [163], and it has been reported that TNFi impact T cell populations in SpA patients [94][95][96][97]. All these observations suggest that analyzing changes in immune cells populations in SpA patients undergoing treatment may be of interest to explore disease mechanisms and therapeutic correlations.…”

Role of Th22 Cells in Human Viral Diseases

“…TNF-α is a cytokine secreted by Th22 cells and Th17 cells. Andersen et al used anti-TNF-α to treat patients with spondyloarthritis (SpA) for 52 weeks of treatment ( 33 ). In this time, the number of Th22 cells and Th17 cells increased continuously, while the expression of IL-23 receptor decreased significantly.…”