Th17 and Treg Balance in Children With Obesity and Metabolically Altered Status.

Valeria Calcaterra,Federica Vinci,Annalisa De Silvestri,Stefania Croce,Gian Vincenzo Zuccotti,Chiara Mameli,Erika Cordaro,Maria Antonietta Avanzini,Corrado Regalbuto,Riccardo Albertini

doi:10.3389/fped.2020.591012

Abstract

Background: Chronic low-grade inflammation and activation of the immune system are hallmark pathogenic mechanisms involved in metabolic dysfunction and are related to obesity. In particular, the involvement of regulatory and pro-inflammatory lymphocyte subpopulations has been reported in adults. We evaluated the Th17/Treg lymphocyte balance in obese and normal weight children, in relation with their metabolic status.Methods: We enrolled 50 pediatric patients. According to metabolic status, subjects were classified into: metabolically healthy (MH) and metabolically unhealthy (MU) groups. MU phenotype was defined as the presence of at least one of the following risk factors: blood pressure >90th percentile, glycemia>100 mg/dl, HDL cholesterol <40 mg/dl, triglycerides>100 mg/dl (<10 years) or >130 mg/dl (>10 years), impaired insulin sensitivity with HOMA-IR>97.5th percentile. Patient Treg and Th17 profiles were also evaluated.Results: Based on the presence of metabolic and/or cardiovascular pathological parameters, we classified 15 MU (30%) and 35 MH (70%) children; all MU children were obese. Analyzing the correlations between lymphocyte subpopulations and metabolic data, we noted a correlation between Th17 percentage and systolic hypertension (p = 0.01, r = −0.37); Treg/Th17 ratio and HOMA-IR (p = 0.02, r = 0.32) and systolic hypertension (p = 0.05, r = 0.30).Conclusion: Children with obesity have a high risk of developing metabolic and cardiovascular complications. The Th17/Treg lymphocyte balance appears to be involved in glycemic homeostasis and blood pressure control. Careful and early monitoring of the immune system would facilitate new early preventive strategies in pediatric metabolic diseases.

Highlights

The global obesity epidemic is worrying considering the involvement of children and adolescents [1,2,3,4,5]
The role of Th17/T regulatory cells (Treg) cell balance has been reported in the development and progression of insulin resistance [35], type 2 diabetes [36], non-alcoholic fatty liver disease [37,38,39], and atherosclerosis [40]
The aim of this study was to evaluate the Th17/Treg lymphocyte balance in obese and normal weight children, in relationship with their metabolic status, in order to define its role in the development of metabolic complications

Summary

Introduction

The global obesity epidemic is worrying considering the involvement of children and adolescents [1,2,3,4,5]. It is largely recognized that chronic low-grade inflammation and activation of the immune system are involved in the pathogenic mechanisms of metabolic dysfunction [30]. Data from the literature, both in experimental and human models, show the involvement of regulatory and pro-inflammatory lymphocyte subpopulations, such as T regulatory cells (Treg) and Th17. Chronic low-grade inflammation and activation of the immune system are hallmark pathogenic mechanisms involved in metabolic dysfunction and are related to obesity. We evaluated the Th17/Treg lymphocyte balance in obese and normal weight children, in relation with their metabolic status

Objectives

Methods

Results

Conclusion