Imbalance of peripheral blood Th17/Treg increases neutrophil-to-lymphocyte ratio in patients with dermatomyositis.

Objective: To explore and analyze the association between peripheral blood Th17/Treg balance and neutrophil-to-lymphocyte ratio (NLR) in patients with dermatomyositis (DM).

Methods: Data of 83 DM patients hospitalized between January 2020 to April 2022 were collected, including 43 patients in the active phase (DM active-phase group) and 40 in the remission phase (DM remission-phase group). Additionally, data of 50 healthy subjects who underwent physical examinations and immunologic function testing in the same period were taken as a control group. We detected the percentage of Th17 and Treg cells by flow cytometry, calculated patient's NLR and laboratory test indicators, and analyzed the correlation of Th17/Treg balance with NLR and laboratory indicators.

Results: Th17 percentage and Th7/Treg ratio in the DM active-phase group were higher than those in the DM remission-phase group (), while Treg percentage was lower in the active-phase group than in the remission-phase group (). The creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), erythrocyte deposition rate (ESR), and NLR in DM patients were significantly higher than those of the control group (P<0.05), and were associated with the disease activity of DM. The ratio of Th17/Treg was positively correlated with CK, LDH, AST, ALT, ESR, and NLR (). NLR was positively correlated with CK, LDH, AST, ALT, and ESR ().

Conclusion: DM patients exhibit changes in immune balance of Th17/Treg and an increase in the NLR. The Th17/Treg ratio in the patients is closely associated with the NLR, which suggests that the immune balance mechanism may interact with the inflammatory response of the body, collectively contributing to the progression of DM.