Journal
FRONTIERS IN IMMUNOLOGY
Volume 13, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.893702
Keywords
calcitriol; progesterone; steroid resistance; T helper 17; 1; multiple sclerosis
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The study demonstrates that glucocorticoid sensitivity of Th17.1 cells can be enhanced through treatment with calcitriol and further improved with progesterone. This finding opens up a new therapeutic avenue for Th17.1-associated inflammatory diseases, including multiple sclerosis.
In early multiple sclerosis (MS), an IFN-gamma(high)GM-(CSFIL)-I-high-17(low) CD4(+) T-cell subset termed T helper 17.1 (Th17.1) reveals enhanced capacity to infiltrate the central nervous system. Th17.1 cells express high levels of multidrug resistance protein 1 (MDR1), which contributes to their poor glucocorticoid responsiveness. In this study, we explored whether glucocorticoid sensitivity of Th17.1 cells can generically be improved through synergy between steroid hormones, including calcitriol (1,25(OH)(2)D-3), estradiol (E2) and progesterone (P4). We showed that human blood Th17.1 cells were less sensitive to 1,25(OH)(2)D-3 than Th17 cells, as reflected by lower vitamin D receptor (VDR) levels and reduced modulation of MDR1, IFN-gamma and GM-CSF expression after 1,25(OH)(2)D-3 exposure. Upon T-cell activation, VDR levels were increased, but still lower in Th17.1 versus Th17 cells, which was accompanied by a 1,25(OH)(2)D-3-mediated decline in MDR1 surface expression as well as secretion of IFN-gamma and GM-CSF. In activated Th17.1 cells, 1,25(OH)(2)D-3 amplified the suppressive effects of methylprednisolone (MP) on proliferation, MDR1 surface levels, secretion of IFN-gamma and granzyme B, as well as expression of brain-homing markers CCR6 and VLA-4. The addition of P4 to 1,25(OH)(2)D-3 further enhanced MP-mediated reduction in proliferation, CD25, CCR6 and CXCR3. Overall, this study indicates that glucocorticoid sensitivity of Th17.1 cells can be enhanced by treatment with 1,25(OH)(2)D-3 and further improved with P4. Our observations implicate steroid hormone crosstalk as a therapeutic avenue in Th17.1-associated inflammatory diseases including MS.
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