Study on the relationship between disease progression and changes in Th17/Treg levels in patients with relapsing-remitting multiple sclerosis.

OBJECTIVE: This study aims to investigate the relationship between disease progression and changes in Th17/Treg levels in patients with relapsing-remitting multiple sclerosis (RRMS). METHODS: This retrospective study analyzed clinical data and Th17/Treg cell levels from 130 RRMS patients and 100 non-inflammatory neurological disease controls treated between December 2021 and January 2025. Th17 cells were identified as CD4+IL-17A+ cells and Treg cells as CD4+CD25+Foxp3+ cells via flow cytometry. RESULTS: The two groups were comparable in baseline characteristics (p > 0.05). The proportion of CD4+IL-17A+ Th17 cells was significantly higher in RRMS patients than in controls (4.26 ± 1.35% vs. 1.52 ± 0.47%, p < 0.05), while CD4+CD25+Foxp3+ Treg cells were significantly lower (2.91 ± 0.98% vs. 5.38 ± 1.52%, p < 0.05). Acute-phase patients showed higher Th17 and lower Treg proportions than remission-phase patients (p < 0.05). Following methylprednisolone treatment, Th17 cells decreased, Treg cells increased, and EDSS scores improved (p < 0.05 for all). Pearson correlation analysis revealed that Th17 proportion and Th17/Treg ratio were positively correlated with EDSS scores (r = 0.521, p < 0.01; r = 0.485, p < 0.001), while Treg proportion was negatively correlated (r = -0.387, p < 0.05). CONCLUSION: Th17/Treg imbalance may be an important mechanism underlying RRMS pathogenesis and disease progression. Modulating this balance may represent a promising therapeutic target for RRMS.