The Alterations in and the Role of the Th17/Treg Balance in Metabolic Diseases
Open accessAbstract
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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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 measuredA 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)
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Obesity and Autoimmunity Epidemic: The Role of Immunometabolism
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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
- Publisher
- Frontiers Media SA
- Published
- 2021-07-12
- Volume
- 12
- Pages
- 678355-678355
- ISSN
- 1664-3224 (ISSN-L)
- PMC
- PMC8311559
- 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
- gold
- doi.org
- Licence
- 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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