Study Identifies Altered T Cell Profiles and IL-23/Th17 Pathway Dysregulation in Endometriosis
Researchers profiling immune responses in endometriosis patients found significant dysregulation of Th17 cells and related cytokines across blood, peritoneal fluid, and tissue samples. The study used flow cytometry and bulk RNA sequencing to characterize T helper cell subsets across disease stages, revealing over 2,200 differentially expressed genes in Th17 cells alone. The findings suggest that therapies already approved for other inflammatory diseases targeting the IL-23/IL-17 pathway could be repurposed to treat endometriosis.
A new preprint study published on bioRxiv investigated the role of the IL-23/Th17 immune axis in endometriosis (EMS), a chronic inflammatory condition affecting millions of women worldwide. Researchers measured cytokines and chemokines in patient plasma, peritoneal fluid, and matched eutopic and ectopic tissue samples, finding elevated levels of IL-6 in plasma, FLT-3L and G-CSF in eutopic tissue, and IL-1RA and IL-23 in peritoneal fluid among severe-stage patients. Flow cytometry showed that pathogenic Th17 cells were disproportionately elevated in peritoneal fluid compared to non-pathogenic Th17 and regulatory T cell subsets. Notably, circulating Th17 cells were higher in mild-stage (I-II) than severe-stage (III-IV) disease, suggesting dynamic immune remodeling as the condition progresses. RNA sequencing identified 2,220 differentially expressed genes in Th17 cells, the most extensive transcriptomic reprogramming observed among all T helper subsets studied. The authors propose that IL-23- and IL-17-targeted biologics, already in clinical use for conditions such as psoriasis and inflammatory bowel disease, could be evaluated as therapeutic options for endometriosis and its associated comorbidities.
What's missing
It is unclear whether the transcriptomic changes observed are causally linked to disease pathogenesis or are secondary effects. Long-term functional consequences of Th17 reprogramming and whether IL-23/IL-17-targeted therapies would be safe and effective specifically in endometriosis patients remain open questions requiring clinical investigation.
What different sources said
- bioRxivCenter
An investigation of the IL-23/Th17 axis and transcriptomic profiles of T helper subsets in endometriosis
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