Conclusions
While our study has some limitations, including a small sample size,
absence of treatment naïve patients, and the lack of confirmative
studies using animal model, we found an impressive interaction between
the increased frequency of cTfh cells, particularly cTfh17.1 cells and
the enhanced production of IL-21 in MS patients. Contrarily, cTfreg
cells and their signature cytokine IL-10 were remarkably impaired in MS
patients. Taken together, our study demonstrates an alteration of cTfh
and cTfreg cells, which is reflected in the dysregulated cytokine
production in MS. An additional study with a larger cohort is warranted
to validate our observations regarding the role of Tfh cells and their
subsets as well as Tfreg cells in MS. Functional analysis throughin vitro co-culture of purified cTfh, B and cTfreg cells may
provide a better understanding of MS and other autoimmune diseases that
could potentially guide us to new therapeutic interventions.