Juvenile Idiopathic Arthritis (JIA) is currently classified into seven subgroups. Recently, antinuclear antibody (ANA) positive JIA patients were suggested to encompass a clinically homogenous new subgroup. CD4⁺ T helper (Th) cells play an essential role in JIA pathogenesis. Herein, we analyzed cytokine expression in synovial fluid (SF) CD4⁺ Th cells of JIA patients by using flow cytometry and compared cytokine patterns between JIA subgroups. We could show increased frequencies of IL-21 expressing CD4+ Th cells in the joints of ANA+ Oligo-/Poly-JIA patients, which co-expressed the Th-1 cytokines IFN-γ/TNF-α. In contrast, frequencies of IL-17 expressing cells were lowest in the joints of ANA+ Oligo-/Poly-JIA but enriched in that of ERA-JIA patients. This is the first description of a diverse SF Th cell cytokine pattern in different JIA subgroups. Additionally, we could define IL-21 as an effector cytokine expressed in SF Th cell in a significant proportion of ANA+ JIA patients.

青少年特发性关节炎（JIA）当前分为七个亚组。最近，建议抗核抗体（ANA）阳性的JIA患者包括临床同质的新亚组。CD4 ⁺ T辅助（Th）细胞在JIA发病机理中起重要作用。在这里，我们分析了滑液（SF）CD4 ^+中的细胞因子表达使用流式细胞仪对JIA患者的Th细胞进行比较，并比较JIA亚组之间的细胞因子模式。我们可以显示ANA + Oligo- / Poly-JIA患者关节中IL-21表达CD4 + Th细胞的频率增加，这些患者共表达Th-1细胞因子IFN-γ/TNF-α。相反，在ANA + Oligo- / Poly-JIA的关节中，表达IL-17的细胞的频率最低，而在ERA-JIA患者中则丰富。这是对不同JIA亚​​组中多种SF Th细胞细胞因子模式的首次描述。此外，我们可以将IL-21定义为在ANA + JIA患者中有相当一部分在SF Th细胞中表达的效应细胞因子。