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Vol. 19. Issue 3.
Pages 143-149 (March 2023)
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Vol. 19. Issue 3.
Pages 143-149 (March 2023)
Original article
Peripheral T helper subset profiling in idiopathic inflammatory myositis: Proof of concept
Perfil de subconjunto auxiliar T periférico en miositis inflamatoria idiopática: prueba de concepto
Anamika Kumari Anujaa, Pankti Mehtaa, Mantabya Kumar Singhc, Harshit Singha, Alok Nathb, Zia Hashimb, Ajmal Khanb, Mansi Guptab, Durga P. Misraa, Vikas Agarwala,
Corresponding author

Corresponding authors.
, Latika Guptaa,d,e,f,
Corresponding author

Corresponding authors.
a Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
b Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
c Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
d Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
e City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
f Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK
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There is a dearth of biomarkers in Idiopathic Inflammatory Myopathies (IIM) to recognize ongoing muscle inflammation and distinguish damage from activity. Since IIM is an autoantibody-mediated disease with tertiary lymphoid organogenesis reported in the diseased muscles, we aimed to study the peripheral blood T helper (Th) subset profiling as a plausible reflection of ongoing muscle inflammation.


Fifty-six patients of IIM were compared with 21 healthy controls (HC) and 18 patients with sarcoidosis. Th1, Th17, Th17.1, and Treg cells were identified after stimulation assays (BD Biosciences). Myositis autoantibodies were tested by line immunoassay (Euroimmune, Germany).


All Th subsets were elevated in IIM as compared with HC. As compared to HC, PM had elevated Th1 and Treg while Th17 and Th17.1 populations were higher in OM. Patients with sarcoidosis had higher Th1 and Treg but lower Th17 population as compared to IIM {Th1(69.1% vs 49.65%, p<0.0001), {Treg (12.05% vs 6.2%, p<0.0001), {Th17 (2.49% vs 4.4%, p<0.0001)}. Similar results were obtained when sarcoidosis ILD was compared with IIM ILD with a higher Th1 and Treg population but lower Th17 population in the former. No difference in T cell profile was observed after stratification for MSA positivity, type of MSA, clinical features of IIM and disease activity.


Th subsets in IIM are distinct from sarcoidosis and HC with a TH17 predominant paradigm, creating a case of exploring Th17 pathway and IL-17 blockers for the treatment of IIM. However, cell profiling cannot distinguish active from inactive disease limiting its predictive potential as a biomarker of activity in IIM.

Th17 cells
Lung diseases

Hay una escasez de biomarcadores en las miopatías inflamatorias idiopáticas (MII) para reconocer la inflamación muscular en curso y distinguir el daño de la actividad. Dado que la MII es una enfermedad mediada por autoanticuerpos con organogénesis linfoide terciaria informada en los músculos enfermos, nuestro objetivo fue estudiar el perfil del subconjunto de linfocitos T helpers (Th) de sangre periférica como un reflejo plausible de la inflamación muscular en curso.


Se compararon 56 pacientes de MII con 21 controles sanos (CS) y 18 pacientes con sarcoidosis. Las células Th1, Th17, Th17.1 y Treg se identificaron después de los ensayos de estimulación (BD Biosciences). Los autoanticuerpos de miositis se analizaron mediante inmunoanálisis en línea (Euroimmune, Alemania).


Todos los subconjuntos de Th estaban elevados en las MII en comparación con los CS. En comparación con los CS, PM tenía Th1 y Treg elevados, mientras que las poblaciones de Th17 y Th17.1 eran más altas en OM. Los pacientes con sarcoidosis tenían una población Th1 y Treg más alta pero una población Th17 más baja en comparación con MII {Th1 (69,1% frente a 49,65%, p<0,0001), {Treg (12,05% frente a 6,2%, p<0,0001), {Th17 (2,49% frente a 4,4%, p<0,0001)}. Se obtuvieron resultados similares cuando se comparó la EPI de sarcoidosis con la EPI de las MII con una mayor población Th1 y Treg pero menor población Th17 en la primera. No se observaron diferencias en el perfil de células T después de la estratificación por positividad de MSA, tipo de MSA, características clínicas de las MII y actividad de la enfermedad.


Los subconjuntos de Th en las MII son distintos de la sarcoidosis y los CS con un paradigma predominante TH17, lo que crea un caso de exploración de la vía Th17 y los bloqueadores de IL-17 para el tratamiento de las MII. Sin embargo, el perfil celular no puede distinguir la enfermedad activa de la inactiva, lo que limita su potencial predictivo como biomarcador de actividad en las MII.

Palabras clave:
Células Th17
Enfermedades pulmonares


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