Cited by 263Adipokines, Inflammation, and Metabolic DiseasesPsoriasis: Treatment and PathogenesisT-cell and B-cell Immunology

The Alterations in and the Role of the Th17/Treg Balance in Metabolic Diseases

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Zhang, Siwen, Gang, Xiaokun, Yang, Shuo, Cui, Mengzhao, Sun, Lin, Li, Zhuo, Wang, Guixia·2021·Frontiers in Immunology

Abstract

Chronic inflammation plays an important role in the development of metabolic diseases. These include obesity, type 2 diabetes mellitus, and metabolic dysfunction-associated fatty liver disease. The proinflammatory environment maintained by the innate immunity, including macrophages and related cytokines, can be influenced by adaptive immunity. The function of T helper 17 (Th17) and regulatory T (Treg) cells in this process has attracted attention. The Th17/Treg balance is regulated by inflammatory cytokines and various metabolic factors, including those associated with cellular energy metabolism. The possible underlying mechanisms include metabolism-related signaling pathways and epigenetic regulation. Several studies conducted on human and animal models have shown marked differences in and the important roles of Th17/Treg in chronic inflammation associated with obesity and metabolic diseases. Moreover, Th17/Treg seems to be a bridge linking the gut microbiota to host metabolic disorders. In this review, we have provided an overview of the alterations in and the functions of the Th17/Treg balance in metabolic diseases and its role in regulating immune response-related glucose and lipid metabolism.

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Crossref · 10.3389/fimmu.2021.678355

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  • The hepatic microenvironment in MASLD favors Th17 differentiation by upregulating RORγt while destabilizing FOXP3 in Tregs, leading to their phenotypic conversion into pro-inflammatory subsets.

    “The hepatic microenvironment in MASLD favors Th17 differentiation by upregulating retinoic acid-related orphan receptor gamma t (RORγt) expression while concurrently destabilizing FOXP3 in Tregs, leading to their phenotypic conversion into pro-inflammatory subsets (Zhang et al. 2021).”

    From The double-edged sword of regulatory T cells in MASLD: from inflammation control to fibrosis promotion (2026) · cites this paper as Zhang et al. 2021

    The MAFLD section (page unavailable) links liver damage and increased IL-23 to a Th17 response. The regulation and epigenetic sections (pages unavailable) describe RORγt-driven Th17 differentiation, Foxp3 degradation, and cytokine-dependent conversion of induced Tregs into Th17 cells. They do not establish that the hepatic microenvironment in MAFLD causes that specific RORγt–Foxp3 sequence or Treg conversion; the MAFLD section also reports elevated liver-resident Foxp3 expression with hypercholesterolemia. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • A reduction in Treg numbers under sustained disease leads to increased Th17/Treg imbalance and aberrant activation of pro-inflammatory T cell subsets, resulting in hepatocyte injury and exacerbation of liver inflammation.

    “Since Tregs are immunoregulatory cells capable of suppressing pro-inflammatory cytokine production by effector T cells, such as Th1 and Th17 cells (Workman et al. 2009), a reduction in Treg numbers under sustained disease conditions leads to an increased Th17/Treg imbalance and aberrant activation of pro-inflammatory T cell subsets, ultimately resulting in hepatocyte injury and exacerbation of”

    From The double-edged sword of regulatory T cells in MASLD: from inflammation control to fibrosis promotion (2026) · cites this paper as Zhang et al. 2021

    The MAFLD section reports fewer liver-resident Tregs in NAFLD animal models, increased Th17 cells in NASH, and reduced hepatic inflammation after Treg transfer. It does not establish the claimed causal chain from Treg loss through aberrant T-cell activation to hepatocyte injury; it also notes contradictory findings on Treg numbers in humans. No page number is available in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Authors
Zhang, S., Gang, X., Yang, S., Cui, M., Sun, L., Li, Z., & Wang, G.
Affiliations
First Hospital of Jilin University (CN)
Corresponding author
  • Li, Zhuo
  • Wang, Guixia
Venue
Frontiers in Immunology
Published
2021-07-12
Volume
12
Pages
678355-678355
ISSN
1664-3224 (ISSN-L)
OpenAlex
W3178963741
Cited by
263
References
150
Citations by year
2026: 49 · 2025: 97 · 2024: 46 · 2023: 43 · 2022: 26 · 2021: 2
FWCI
4.48
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • People's Government of Jilin Province
  • Department of Science and Technology of Jilin Province (20170623005TC)
Topics
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
Keywords
Th17/Treg balance, regulatory T cells, Th17 cells, chronic inflammation, metabolic disorders, obesity, type 2 diabetes, non-alcoholic fatty liver disease, innate immunity, macrophages, inflammatory cytokines, energy metabolism, epigenetic regulation, gut microbiota, glucose metabolism, lipid metabolism
MeSH terms
Animals, Disease Susceptibility, Humans, Inflammation, Lymphocyte Activation, Metabolic Diseases, Signal Transduction, Biomarkers, Cytokines, Lymphocyte Count, Adipogenesis, T-Lymphocytes, Regulatory, Th17 Cells, Cellular Microenvironment

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