Elevated Th22 cells correlated with Th17 cells in patients with high liver stiffness in nonalcoholic fatty liver disease

The aims of this article are to investigate the effects of Th22 and Th17 cells and plasma cytokines in patients with nonalcoholic fatty liver disease (NAFLD) and to examine the correlation between Th22 and Th17 cells levels and disease progression. Blood samples from 70 patients with NAFLD and 26 healthy controls (HCs) were collected. Flow cytometry and enzyme-linked immunosorbent assay (ELISA) analysis were performed. ELISA revealed interleukin (IL)-22 plasma level in FibroScan subgroup patients was 2.2-fold higher than that in the HCs ( P < 0.01), body mass index (BMI) subgroup patients were 2.3-fold higher than HCs ( P < 0.01), IL-17A plasma level was 5.6-fold higher in FibroScan subgroup patients than that in the HCs ( P < 0.01), and 5.8-fold higher in BMI subgroup than HCs ( P < 0.01). Flow cytometry revealed median proportions of Th22 cells in FibroScan group was greater than that in the HCs (3.85% vs 0.86%; P < 0.001). Similar results were obtained for Th17 cells (6.36% vs 0.9%; P < 0.001). The liver stiffness measurement value was highly correlated with the proportion of Th17 and Th22 cells and moderately correlated with the plasma level of IL-17A, IL-22, and the BMI value. In conclusion, the elevated proportions of Th17 and Th22 cells were significantly correlated with the degree of liver cirrhosis in NAFLD patients. They may play an inflammatory and immune response role in progression from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) or fibrosis.