Background/Purpose: To investigate the efficacy of tofacitinib (TOF) in patients with active TAK, explore the effect on CD4+ regulatory T cells (Tregs) homeostasis and relationship with clinical outcomes.

Methods: This was a prospective, open-label cohort study. Thirty-four active TAK patients and 28 healthy controls (HCs) of comparable sex and age were recruited. All the patients were treated with glucocorticoids (GCs) and TOF. Complete response (CR) was assessed at the 6th month and relapse was recorded after CR, inflammatory parameter, GCs dose, vascular imaging, frequency and cytokine production of CD4+ regulatory T cells were evaluated for 24month follow-up. SPSS 22.0(SPSS, USA) was employed for data analysis. P< 0.05 indicated statistical significance.

Results: 1. CR was reached in 26/34 (76.47%) patients at 6th month. In responders group, the mean dosage of steroids and acute-phase reactants significantly decreased after 6 months TOF therapy.2. In active TAK, the frequence of CD4+CD25+Foxp3+ Tregs and the percentage of Foxp3+ in CD4+CD25high T cells decreased, but IFN-γ+ and IL-17+ Tregs increased. Inflammatory Tregs correlated with disease activity parameters positively. 3.After 6months TOF efficiency therapy, the percentage of IFN-γ+ and IL-17+Tregs decreased, but the frequence of CD4+CD25+Foxp3+ Tregs and the percentage of Foxp3+ in CD4+CD25high T cells increased in CR group, and the alterations existed during 24 months follow up.

Conclusion: Decreased CD4+Tregs displaying reduced expression of FOXP3, increased expression of IFN-γ and IL-17 have been implicated in the pathogenesis of TAK.TOF therapy can be a promising treatment for active TAK patients and improving the Tregs defects.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/defective-cd4-regulatory-t-cells-in-active-takayasu-arteritis-patients-can-be-improved-by-efficiency-treatment-of-tofacitinib/