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2017 ; 14
(5
): 423-431
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The regulation of the Treg/Th17 balance by mesenchymal stem cells in human
systemic lupus erythematosus
#MMPMID26435067
Wang D
; Huang S
; Yuan X
; Liang J
; Xu R
; Yao G
; Feng X
; Sun L
Cell Mol Immunol
2017[May]; 14
(5
): 423-431
PMID26435067
show ga
BACKGROUND AND OBJECTIVE: Umbilical cord (UC)-derived mesenchymal stem cells
(MSCs) have shown immunoregulation of various immune cells. The aim of this study
was to investigate the mechanism of UC MSCs in the regulation of peripheral
regulatory T cells (Treg) and T helper 17 (Th17) cells in patients with systemic
lupus erythematosus (SLE). METHODS: Thirty patients with active SLE, refractory
to conventional therapies, were given UC MSCs infusions. The percentages of
peripheral blood CD4+CD25+Foxp3+ regulatory T cells (Treg) and CD3+CD8-IL17A+
Th17 cells and the mean fluorescence intensities (MFI) of Foxp3 and IL-17 were
measured at 1 week, 1 month, 3 months, 6 months, and 12 months after MSCs
transplantation (MSCT). Serum cytokines, including transforming growth factor
beta (TGF-?), tumor necrosis factor alpha (TNF-?), interleukin 6 (IL-6), and
IL-17A were detected using ELISA. Peripheral blood mononuclear cells from
patients were collected and co-cultured with UC MSCs at ratios of 1:1, 10:1, and
50:1, respectively, for 72 h to detect the proportions of Treg and Th17 cells and
the MFIs of Foxp3 and IL-17 were determined by flow cytometry. The cytokines in
the supernatant solution were detected using ELISA. Inhibitors targeting TGF-?,
IL-6, indoleamine 2,3-dioxygenase (IDO), and prostaglandin E2 were added to the
co-culture system, and the percentages of Treg and Th17 cells were observed.
RESULTS: The percentage of peripheral Treg and Foxp3 MFI increased 1 week, 1
month, and 3 months after UC MSCs transplantation, while the Th17 proportion and
MFI of IL-17 decreased 3 months, 6 months, and 12 months after the treatment,
along with an increase in serum TGF-? at 1 week, 3 months, and 12 months and a
decrease in serum TNF-? beginning at 1 week. There were no alterations in serums
IL-6 and IL-17A before or after MSCT. In vitro studies showed that the UC MSCs
dose-dependently up-regulated peripheral Treg proportion in SLE patients, which
was not depended on cell-cell contact. However, the down-regulation of Th17 cells
was not dose-dependently and also not depended on cell-cell contact. Supernatant
TGF-? and IL-6 levels significantly increased, TNF-? significantly decreased, but
IL-17A had no change after the co-culture. The addition of anti-TGF-? antibody
significantly abrogated the up-regulation of Treg, and the addition of PGE2
inhibitor significantly abrogated the down-regulation of Th17 cells. Both
anti-IL-6 antibody and IDO inhibitor had no effects on Treg and Th17 cells.
CONCLUSIONS: UC MSCs up-regulate Treg and down-regulate Th17 cells through the
regulation of TGF-? and PGE2 in lupus patients.