Correlations of expressions of Toll-like receptor 4 and Janus kinase 3 in peripheral blood mononuclear cells with T helper 17 cell/regulatory T cell imbalance in patients with ankylosing spondylitis

Background: We aimed to analyze the correlations of the expressions of Toll-like receptor 4 (TLR4) and Janus kinase 3 (JAK3) in peripheral blood mononuclear cells (PBMCs) with T helper 17 cell (Th17)/regulatory T cell (Treg) imbalance in patients with ankylosing spondylitis (AS). Methods: A total of 101 AS patients were enrolled into an AS group. Based on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, they were subdivided into a stable AS (ASS) group (BASDAI score <4 points, n=42) and an active AS (ASA) group (BASDAI score >= 4 points, n=59). Meanwhile, 50 healthy volunteers who received health examination in the same time period were assigned into a healthy control (HC) group. RT-qPCR was performed to determine the mRNA expressions of TLR4 and JAK3 in PBMCs. Enzyme-linked immunosorbent assay was conducted to measure the levels of Th17/Treg-related cytokines [interleukin (IL)-10, IL-17, IL-23, and transforming growth factor-beta (TGF-beta)] in the serum. Results: The mRNA expressions of TLR4 and JAK3 had positive correlations with IL-17 (r=0.592, 0.542) and IL-23 levels (r=0.529, 0.590) (P 0.05). The levels of TLR4 mRNA, JAK3 mRNA, IL-17, and IL-23 were all correlated with the occurrence of AS (P<0.05). The areas under the receiver operating characteristic curves of TLR4, JAK3, and their combination in PBMCs for predicting the occurrence of AS were 0.912, 0.835, and 0.919, respectively. Conclusions TLR4 combined with JAK3 can effectively predict the occurrence of AS.