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The peripheral blood regulatory T-cells analysis as a criterion for assessing the therapy efficacy and a prognostic marker for the duration of remission of psoriasis

Background. The recently discovered regulatory T-cells CD4+CD25+FOXP3+CD127low (Treg-cells) plays an important role in sustaining immune tolerance. These cells demonstrated a significant tremendous potential in suppressing the pathological immune response associated with various autoimmune diseases, including psoriasis vulgaris (VP). 
Aims. To find the role of Treg-cells in VP pathogenesis and to show the possible use of the Treg-cells analysis for diagnosis, remission duration prediction and measurement of therapeutic effectiveness. 
Materials and methods. We studied 60 VP patients (35 females and 25 males) aged 1855. The patients were diagnosed with VP at advanced, remedial and retrogressive phases (28, 19 and 13 participants, respectively). The disease severity was assessed with the PASI (Psoriasis Area and Severity Index). The patients were stratified into two groups based on disease duration (less than 20 years, n = 42; over 20 years, n = 28). The study involved 12 VP patients in the advanced stage, whose Treg level was tested prior and after 311 nm UVB course. We followed up the VP patients for two years following the UVB-311 nm phototherapy course to assess the remission duration and the relapse frequency. 
Results. We found lower levels of Тreg in patients in the study group. Treg peripheral blood levels in VP patients and in HD were 2.84 1.00% and 4.02 0.73%, respectively. The Treg levels were 2.59 0.68%, 2.82 1.55% and 3.68 1.62% at advanced, remedial and retrogressive stages, respectively. The patients with the VP history less than 20 years demonstrated Treg level of 3.42 1.11% and 2.31 0.62% for patients with VP history over 20 years. We found an inverse correlation between the Treg subpopulation CD4+CD25+FOXP3+CD127low and the VP severity level evaluated with PASI (r = 
0.39). The UVB-311 nm phototherapy resulted in the significant Treg level increase in 12 patients (2.11 0.61% and 3.43 1.02% prior and after therapy, respectively). Subsequently, we revealed the direct correlation (r = 0.88) between the Treg cell level increase in patients prior and after the phototherapy and the duration of remission in this group of the VP patients. 
Conclusions. We found decreased in Treg levels in VP patients compared to HD and revealed correlation between Treg-cells level in VP patients and VP phases, duration and the severity of the clinical picture. We demonstrated Treg feasibility as a laboratory indicator of VP therapy treatment with the example of 311 nm UVB and as a predict factor of remission duration.