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Peripheral Treg Levels and Transforming Growth Factor-β (TGFβ) in Patients with Psoriatic Arthritis: A Systematic Review Meta-Analysis

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Abstract

Introduction

Studies on the level of regulatory T (Treg) cells in psoriatic arthritis (PsA) have been controversial, leading to disagreement regarding the role Treg cells play in the pathogenesis of the disease. To clarify the status of Treg cells in patients with PsA, we performed a meta-analysis to determine the levels of Treg cells and serum Treg-associated cytokines in PsA patients.

Methods

According to published data from PubMed, Web of Science, Embase, Clinical Trials.gov, MEDLINE, Web of Knowledge, Cochrane Library, and FDA.gov, we determined the Treg and Treg cytokine levels in patients with PsA. The effect estimates were pooled using a random-effects model.

Results

This meta-analysis included 12 studies. Compared to healthy controls (HCs), the proportions of Treg cells had no significant difference in patients with PsA (based on standardized means[SMD] = − 1.038, 95% confidence intervals[CI] =  − 2.165 to 0.089, p = 0.071). On the basis of subgroup analysis, patients with PsA had a lower percentage of CD4+ Treg cells (SMD = − 1.501, 95% CI − 2.799 to − 0.202, p = 0.023) than OKT8+ Treg (SMD = 0.568, 95% CI − 2.127 to 3.263, p = 0.679). Besides, CD4+CD25+FoxP3+ Treg cells and CD4+CD25highCD127low Treg cells were both significantly decreased on the levels of PBMCs in patients with PsA (SMD = − 0.764, 95% CI − 1.404 to − 0.125, p = 0.019; SMD = − 5.184, 95% CI − 6.955 to − 3.412, p < 0.001). CD4+CD25+FoxP3+ Treg cells were particularly more abundant in the synovial fluid thanin peripheral blood (SMD = 3.288, 95% CI 2.127 to 4.449, p < 0.001). No significant difference was observed in the proportion of CD4+CD25+ Treg cells in peripheral blood and CD4+CD25+FoxP3+ Treg cells in CD4+ T cells (SMD = − 2.498, 95% CI − 7.720 to 2.725, p = 0.349; SMD = − 0.719, 95% CI − 2.525 to 1.086, p = 0.435). PsA patients had decreased cytokines such as transforming growth factor-β (TGFβ) (SMD = − 2.199, 95% CI − 3.650 to − 0.749, p = 0.003).

Conclusions

Treg definition markers influence the scale of Treg cells in patients with PsA. Pathogenesis of PsA may be attributed to an insufficient or malfunctioning Treg population.

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Acknowledgements

Funding

This work was supported by the National Natural Science Foundation of China (No. 82001740), Natural Science Research Project of Shanxi Province (No. 20210302123281) and Doctoral Fund of the Second Hospital of Shanxi Medical University(No. 202001-4). The journal’s Rapid Service Fee was funded by the authors.

Author Contributions

QYS designed the study. LY and JL selected the data. QYS and LY analyzed the data. QYS, XFL and SXZ wrote the manuscript. JQL, JQZ, YZ and LS contributed to manuscript revision, and read and approved the submitted version.

Prior Presentation

An earlier version of this study was presented as a poster in the 23rd Asia‐Pacific League of Associations for Rheumatology (https://onlinelibrary.wiley.com/doi/10.1111/1756-185X).

Disclosures

Qin-Yi Su, Sheng-Xiao Zhang, Liu Yang, Jing Luo, Xiao-Feng Li, Jia-Qi Zhang, Yan Zhang, Jun-Qi Liu and Lei Shi have nothing to disclose.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Data Availability

All data relevant to the study are included in the article or uploaded as online supplementary material.

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Authors and Affiliations

  1. Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China

    Qin-Yi Su, Sheng-Xiao Zhang, Jing Luo, Xiao-Feng Li, Jia-Qi Zhang & Lei Shi

  2. Shanxi Medical University, Taiyuan, China

    Qin-Yi Su, Liu Yang & Yan Zhang

  3. Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Jinzhong, China

    Qin-Yi Su, Sheng-Xiao Zhang, Jing Luo, Jia-Qi Zhang & Jun-Qi Liu

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  1. Qin-Yi Su
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Su, QY., Zhang, SX., Yang, L. et al. Peripheral Treg Levels and Transforming Growth Factor-β (TGFβ) in Patients with Psoriatic Arthritis: A Systematic Review Meta-Analysis. Adv Ther 40, 102–116 (2023). https://doi.org/10.1007/s12325-022-02337-5

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