Yoga maintains Th17/Treg cell homeostasis and reduces the rate of T cell aging in rheumatoid arthritis: a randomized controlled trial

Yoga as a complementary therapy for rheumatoid arthritis: a case-based review

Rheumatoid arthritis (RA) presents patients with chronic pain and functional limitations due to its autoimmune nature. Despite symptomatic and pharmaceutical interventions, many patients experience inadequate relief, prompting exploration into non-pharmacological approaches such as yoga. This study aims to evaluate the effectiveness of yoga as an adjunctive therapy for RA by examining clinical data from patients experiencing chronic pain and limitations. This study analyzed several clinical cases at the Shymkent City Regional Clinical Hospital. Ten RA patients, irrespective of various demographic factors, were enrolled. Parameters including pain intensity, inflammation activity, systolic blood pressure, joint function, and morning stiffness were assessed to gauge the impact of yoga. The findings demonstrated notable positive changes following a three-month yoga program. These changes encompassed enhanced joint health, reduced pain severity, and decreased disease activity. Particularly noteworthy was the reduction in morning stiffness by an average of 31 min, alongside a decrease in the average pain index from 80 mm to 41.5 mm. The mean RA activity level decreased from 5.8 to 4.7. Furthermore, mean systolic blood pressure decreased by 15.5 mmHg, and mean cholesterol levels decreased from 5.3 mmol/L to 4.8 mmol/L. These results underscore the potential significance of yoga as a supplementary intervention for RA. Yoga practice may enhance patients' quality of life and alleviate disease symptoms. Nevertheless, the study's limited sample size necessitates caution, and further research is warranted to validate these findings.

Regulatory T Cell and T Helper 17 Cell Imbalance in Patients with Unexplained Infertility

Purpose

Female infertility is a global health concern. The aim of this study was to investigate the relationship between regulatory T (Treg) cells and helper T cells 17 (Th17) in peripheral blood and unexplained infertility (UI). In addition, we explored potential valuable diagnostic biomarkers for patients with UI and ascertained whether Treg and Th17 cells are associated with primary and secondary UI.

Patients and Methods

The patients underwent standard fertility evaluation test, including blood tests, ultrasound examination, fallopian tube tests, ovulation assessment, and male partner's semen analysis. According to the inclusion and exclusion criteria, this study enrolled 37 patients with UI (30 with primary UI and 7 with secondary UI) and 26 age-matched healthy volunteers as the control group. Flow cytometry was used to detect the frequency of Treg and Th17 cells. The area under the receiver operating characteristic curve (AUC) with a 95% confidence interval (CI) was used to assess the diagnostic performance. An AUC > 0.800 indicated good diagnostic performance.

Results

The percentage of Treg decreased significantly, whereas the percentage and absolute count of Th17 cells increased. Moreover, the Th17/Treg ratio in patients with UI increased significantly. As a diagnostic biomarker for UI, the Th17/Treg ratio exhibited remarkable diagnostic performance (AUC: 0.813 (95% CI = 0.709-0.917)). However, the percentages and absolute counts of Treg and Th17 cells in the peripheral blood of women with primary and secondary UI, as well as their Th17/Treg ratios, did not differ significantly.

Conclusion

The distribution of Treg and Th17 cells is imbalanced in patients with UI. Therefore, the Th17/Treg ratio may be a promising indicator of UI. However, there were no significant differences in the distribution of Treg and Th17 cells between women with primary and secondary UI.

Assessing the causal role of immune traits in rheumatoid arthritis by bidirectional Mendelian randomization analysis

Rheumatoid arthritis (RA) is one of the most common autoimmune joint disorders that leads to cartilage degradation. However, its specific correlation with immune cells has not been thoroughly clarified. Based on the two-sample Mendelian randomization (MR) analysis, the association between RA and 731 immune phenotypes which include morphological parameters (MP), relative cell (RC), median fluorescence intensities (MFI), and absolute cells (AC) was comprehensively determined. After false discovery rate correction, RA and immunophenotypes were statistically associated with each other. It was observed that four immune phenotypes, including 1 MPs, 8 RCs, 15 MFIs, and 10 ACs were causally associated with the risk of RA. Meanwhile, several identified immune traits could serve as independent factors for RA and be robust against pleiotropy. While considering the role of RA in immune traits, the involvement of RA in multiple immunophenotypes including CD62L- myeloid DC AC, CD3 on secreting Treg, CD3 on activated and secreting Treg, and CD3 on CD4 Treg was revealed. This study is the first comprehensive evaluation of the interaction between immune response and RA risk, thus providing therapeutic strategies for RA from an immunological perspective.

Augmenting regulatory T cells: new therapeutic strategy for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune condition marked by inflammation of the joints, degradation of the articular cartilage, and bone resorption. Recent studies found the absolute and relative decreases in circulating regulatory T cells (Tregs) in RA patients. Tregs are a unique type of cells exhibiting immunosuppressive functions, known for expressing the Foxp3 gene. They are instrumental in maintaining immunological tolerance and preventing autoimmunity. Increasing the absolute number and/or enhancing the function of Tregs are effective strategies for treating RA. This article reviews the studies on the mechanisms and targeted therapies related to Tregs in RA, with a view to provide better ideas for the treatment of RA.