Interleukin-17-expressing CD4+ T helper 17 (Th17) cells are considered to be critical regulators of thymic inflammation in AChR-MG patients. However, Th17 cells are functionally heterogeneous and circulating Th17 subsets are incompletely understood in AChR-MG patients. Here, we studied characteristics of Th17 subsets in peripheral blood from treatment-naïve AChR-MG patients, patients treated with immunosuppressants, as well as healthy controls. We found increased frequencies of circulating Th1-like Th17 (Th1/17) (IFN-γ + IL-17 + CD4 + CD3+) cells, which declined earlier than conventional Th17 (IFN-γ − IL-17 + CD4 + CD3+) cells in patients who respond well to immunosuppression treatment. Additionally, circulating Th1/17 cell frequencies were found to correlate positively with disease severity. Further, compared to conventional Th17 cells, Th1/17 cells showed an elevated expression of IFNG, TBX21, IL23R, CSF2, and a reduced expression of AHR and IL10. Taken together, our results suggest circulating Th1/17 cells may serve as a biomarker of disease severity and provide a strong rationale for early intervention in AChR-MG patients.

表达白介素17的CD4 + T辅助细胞17（Th17）细胞被认为是AChR-MG患者胸腺炎症的关键调节剂。但是，Th17细胞在功能上是异质的，在AChR-MG患者中，循环中的Th17亚型还不完全清楚。在这里，我们研究了未经治疗的AChR-MG患者，接受免疫抑制剂治疗的患者以及健康对照组的外周血Th17亚型的特征。我们发现循环中的Th1类Th17（Th1 / 17）（IFN-γ+ IL-17 + CD4 + CD3 +）细胞的频率增加，其下降速度比传统Th17（IFN-γ-IL-17 + CD4 + CD3 +）细胞更早对免疫抑制治疗反应良好的患者。此外，发现循环中的Th1 / 17细胞频率与疾病严重程度呈正相关。此外，与传统的Th17细胞相比，IFNG，TBX21，IL23R，CSF2以及AHR和IL10的表达降低。综上所述，我们的研究结果表明循环中的Th1 / 17细胞可能是疾病严重程度的生物标志，并为AChR-MG患者的早期干预提供了强有力的依据。