Restoring the Treg cell to Th17 cell ratio may alleviate HBV-related acute-on-chronic liver failure

Figure 1 Percentages of T helper 17 cells and regulatory T cells, and the ratio of regulatory T cells to T helper 17 cells in hepatitis B virus-related acute-on-chronic liver failure, chronic hepatitis B, and normal control groups. Typical four-quadrant graphs of CD25⁺FoxP3⁺ cells [regulatory T (Treg)] and IL17⁺ cells [T helper 17 (Th17)] in CD4⁺ cells were divided into three groups (A). The proportion of Treg cells (B) and Th17 cells (C) among CD4⁺ cells, and the Treg cell to Th17 cell ratios (D) were shown as box plot graphs. Acute-on-chronic liver failure (ACLF) vs chronic hepatitis B group (CHB) ^bP < 0.01; ACLF vs normal control group (NC) ^dP < 0.01; CHB vs NC ^fP < 0.01.

Figure 2 Correlation between T helper 17 cells and regulatory T cells counts and clinical parameters in hepatitis B virus-related acute-on-chronic liver failure group. The percentage of regulatory T (Treg) cells was significantly correlated with alanine aminotransferase (ALT) (A), total bilirubin (TBIL) (B), and international normalized ratio (INR) (C). The percentage of T helper 17 (Th17) cells was significantly correlated with ALT (D), TBIL (E), and Model for End-stage Liver Disease (MELD) scores (F).The percentage of Treg cells was significantly correlated with that of Th17 cells (G).

Figure 3 Comparison of regulatory T cells and T helper 17 cell counts, and the regulatory T cell to T helper 17 cell ratio between acute-on-chronic liver failure survivors and non-survivors, as well as those during the peak of acute-on-chronic liver failure severity (total bilirubin peak) and those during the 8^th week of follow-up. Regulatory T (Treg) cell counts (A), T helper 17 (Th17) cell counts (B), and the Treg cell to Th17 cell ratios (C) of acute-on-chronic liver failure (ACLF) non-survivors, as well as those of ACLF survivors during the total bilirubin (TBIL) peak and during the 8^th week of follow-up. ^aP < 0.05, ^bP < 0.01 vs the 8^th week of follow-up in ACLF survivors, ^dP < 0.01 vs non-survivors. Non-survivors: The non-survivors in ACLF group; Survivors: The survivors in ACLF group during the TBIL peak; Improving: The survivors in ACLF group during the 8^th week of follow-up.

Figure 4 Changes in regulatory T cells and T helper 17 cell counts, and regulatory T cells and T helper 17 cell ratios of acute-on-chronic liver failure survivors. Changes in regulatory T (Treg) cell counts (A), T helper 17 (Th17) cell counts (B), and the Treg cell to Th17 cell ratio (C) of six acute-on-chronic liver failure survivors (5 males and 1 female).