Figure 1.
Circulating Treg levels in patients with psoriasis.
(A) Dot plots show percentages of Treg in patients and controls. Horizontal bar indicates mean value. (B) The correlations between Treg levels and the other parameters, such as PASI score, age, disease duration, number of treatments and Th17, Th22 levels were examined.
Figure 2.
Photo(chemo)therapy increases circulating Treg population concomitant with clinical efficacy.
Based on the PASI score, psoriasis lesions improved in all cases. Treg levels before and after photo(chemo)therapy in all patients and in the patients with less than 4.07% Treg, defined as the mean of controls, are shown. The results are presented as mean ± SD *p<0.05 and **p<0.01.
Figure 3.
Photo(chemo)therapy restores dysfunctional Treg in patients with psoriasis.
(A) CD4+T cells were separated with magnetic beads as CD25+T cells or CD25− T cells. CD4+ CD25− T cells were labeled with CFSE, and activated with anti-CD3, CD28 beads for 4 days, with or without CD4+ CD25+T cells (Treg) (CD4+ CD25− T cells : CD4+ CD25+T cells = 2×105 : 1×103). FACS data for a typical patient and control are presented. Cells were gated on CD4+T cells. Treg did not suppress CD4+ CD25− T cell proliferation in patients (lower panels) as effectively as in controls (upper panels). The ability of Treg to suppress the proliferation was referred to as the Treg Functional Ratio, determined by comparing the rate of the proliferated CD4+CD25− T cells with and without CD4+CD25+T cells (Figure S1). Summarized data of Treg Functional Ratio in the patients (n = 14) and in the age-matched controls (n = 11) are shown. *p<0.05 and **p<0.01. Horizontal bar indicates mean value. (B) Correlation coefficient between Treg Functional Ratio and PASI score, age or disease duration (n = 14). (C) A Treg functional assay was performed with PBMC in patients before and after photochemotherapy. Histograms of the proliferated CD4+CD25− T cells with CD4+CD25+T cells in three typical patients before and after treatment are shown. Summarized data of Treg Functional Ratio in the patients (n = 14) are shown. Treg Functional ratio in patients is restored to almost normal levels. *p<0.05.
Figure 4.
Photo(chemo)therapy decreases circulating Th17.
(A) Dot plots show percentages of Th17 in patients and controls. Horizontal bar indicates mean value. Levels of Th17 greater than 3.01%, defined as the mean +1 SD of the control level, was analyzed. The higher levels of Th17 are shown, and those are restored to almost normal levels. *p<0.05. (B) Correlation coefficient between Th17 levels and PASI score, age, disease duration, the number of required treatment and Th22 levels.
Figure 5.
Th17 level is higher in severe and poor-responder patients, Treg level is higher in responder patients.
(A) Psoriasis patients were grouped according to PASI score: 0≦PASI<10; 10≦PASI<20; 20≦PASI<30; 30≦PASI. Dot plots show the levels of Th17 or Treg in each group. Th17 levels in the patients with more than 30 PASI were significantly higher as compared to controls. Horizontal bar indicates mean value. (B) Psoriasis patients were grouped in each treatment group achieving 50%, 75% improvement PASI score from baseline (PASI 50, PASI 75). Dot plots show the levels of Th17 after treatment in each group and controls. Th17 levels after treatment in the patients not achieving PASI 50 were significantly higher than those in the patients achieving PASI 75. (C) Psoriasis patients were grouped according to the amount of decrease in Th17 levels by photo(chemo)therapy: Th17 high increased group n = 16, ΔTh17>1%; Th17 increased group n = 15, ΔTh17>0%; Th17 decreased group n = 24, ΔTh17<0%; Th17 high decreased group n = 13, ΔTh17<−1%. Dot plots show the levels of Treg prior to treatment in each group and controls. The levels of Treg prior to treatment with Th17 high decreased group; ΔTh17<−1% (5.16±2.20%) were significantly higher than that with Th17 high increased group; ΔTh17>1% (3.33±1.39%).