Th1 and Th17 balance in inflammatory myopathies: interaction with dendritic cells and possible link with response to high-dose immunoglobulins

Cytokine. 2009 Jun;46(3):297-301. doi: 10.1016/j.cyto.2009.02.013. Epub 2009 Mar 19.


To clarify the interactions between dendritic cells (DCs) and Th1 and Th17 T cell subsets and the mode of action of IVIG in inflammatory myopathies, Expression of CD4(+) and CD8(+) T cells, immature (CD1a) and mature (DC-LAMP) DCs, interleukin-17 (IL-17) and interferon-gamma (IFN-gamma), was quantified by immunohistochemistry in muscle biopsies from 13 patients (11 with polymyositis (PM) and 2 dermatomyositis (DM)) obtained before treatment with IVIG. The Th1/Th17 cytokine and the immature/mature DC ratio were studied according to the response to IVIG. Immature DCs were rarely detected compared to mature DCs, observed in all samples except one PM. IFN-gamma-producing cell count was higher than IL-17 count. Neither the expression of IFN-gamma nor IL-17 was correlated with that of DC subsets. Seven of the 13 patients (6 PM and 1 DM) responded to IVIG. T cells and DC subsets were not differentially expressed between responders and non-responders. The frequency of IFN-gamma-producing cells was significantly higher in non-responders with an increased IFN-gamma/IL-17-producing-cell ratio. In conclusion, mature rather than immature DC and IFN-gamma-rather than IL-17-producing cells accumulate in inflamed muscle. Increased IFN-gamma-producing cell count and IFN-gamma/IL-17-ratio were found in IVIG non-responders, suggesting a role for the Th17 mediated pathway in the response to IVIG.

MeSH terms

  • Adolescent
  • Adult
  • Biopsy
  • Dendritic Cells / immunology*
  • Dermatomyositis / drug therapy
  • Dermatomyositis / immunology
  • Female
  • Humans
  • Immunoglobulins, Intravenous* / immunology
  • Immunoglobulins, Intravenous* / therapeutic use
  • Interferon-gamma / immunology
  • Interleukin-17 / immunology*
  • Male
  • Middle Aged
  • Muscle, Skeletal / cytology
  • Muscle, Skeletal / immunology
  • Muscle, Skeletal / pathology
  • Myositis* / drug therapy
  • Myositis* / immunology
  • Polymyositis / drug therapy
  • Polymyositis / immunology
  • T-Lymphocyte Subsets / immunology*
  • Th1 Cells / immunology*
  • Young Adult


  • Immunoglobulins, Intravenous
  • Interleukin-17
  • Interferon-gamma