---
title: "Th17/Treg imbalance in psoriasis patients with metabolic dysfunction‑associated steatotic liver di"
id: "frontiers-in-immunology-12-th17-treg-imbalance-and-clinical-characteristics-in-psoriasis-patients-with"
canonical_url: "https://medichelpline.com/clinical-feed/frontiers-in-immunology-12-th17-treg-imbalance-and-clinical-characteristics-in-psoriasis-patients-with"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "Frontiers in Immunology"
source_url: "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958145"
published_at: "2026-10-09T00:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Th17/Treg imbalance in psoriasis patients with metabolic dysfunction‑associated steatotic liver di
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/frontiers-in-immunology-12-th17-treg-imbalance-and-clinical-characteristics-in-psoriasis-patients-with
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** Frontiers in Immunology
- **Source URL:** [Original Journal Publication](https://www.frontiersin.org/articles/10.3389/fimmu.2026.1958145)
- **Published At:** 2026-10-09T00:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- The article title indicates a cross‑sectional study assessing the relationship between **Th17/Treg imbalance** and clinical characteristics in patients who have both **psoriasis** and **metabolic dysfunction‑associated steatotic liver disease (MASLD)**. - The source provided (Frontiers in Immunology) and the article type (Original Research) are reported, but the body content containing study methods, participant characteristics, measured outcomes, statistics, and conclusions is not present in the source excerpt supplied. - Key concepts inferred from the title only: the study likely examines immune cell subset balance (proinflammatory **Th17** cells versus regulatory **Treg** cells) and correlates immunologic measures with clinical features in a comorbid dermatology‑hepatology population. - The design is stated as **cross‑sectional**, implying simultaneous measurement of immune markers and clinical variables rather than longitudinal follow‑up or intervention. - Specific data points such as sample size, inclusion/exclusion criteria, laboratory assays, imaging or histology for MASLD, psoriasis severity scores, statistical tests, effect sizes, and p values were not reported in the provided source content. - Because the supplied source content lacks results and methods, no factual statements about observed **Th17/Treg** ratios, associations with clinical severity, or mechanistic interpretations can be reported beyond what the title indicates. - Readers interested in detailed findings, clinical associations, or implications for management should consult the full article; the excerpt here does not include that information.
## Clinical Analysis & Structured Key Points
Frontiers | Th17/Treg imbalance and clinical characteristics in psoriasis patients with metabolic dysfunction-associated steatotic liver disease: a cross-sectional analysis ORIGINAL RESEARCH article Front. Immunol. , 09 October 2026 Sec. Inflammation Volume 17 - 2026 | https://doi.org/10.3389/fimmu.2026.1958145 Published in Frontiers in Immunology Inflammation 7 impact factor 11.3 citescore Part of a Research Topic Inflammation at the Crossroads of MASLD: Immunological Mechanisms and Their Interconnections with Other Diseases Submission open 16k views 8 articles Editor & Reviewers Edited by H S Helena Solleiro-Villavicencio Reviewed by E K Eva Klara Merzel Šabović N Z Ningxin Zhang Outline Figures and Tables Figure 1 View in article Figure 2 View in article Table 1 Baseline clinical characteristics of psoriasis patients and routine health-examination group. View in article Table 2 Clinical characteristics of patients with MASLD with or without psoriasis. . View in article Table 3 Distribution of steatosis grade, fibrosis grade, and liver enzymes status across mild, moderate, and severe psoriasis groups. View in article Table 4 Clinical characteristics of patients with psoriasis with or without MASLD. View in article Table 5 Crude and multivariable-adjusted logistic regression analyses of factors associated with MASLD in psoriasis patients. View in article Table 6 Correlations of Th17-related immune measures with psoriasis severity and hepatic steatosis. View in article Table 7 Binary logistic regression analyses of the associations between immune parameters and MASLD. View in article ORIGINAL RESEARCH article Front. Immunol. , 09 October 2026 Sec. Inflammation Volume 17 - 2026 | https://doi.org/10.3389/fimmu.2026.1958145 Th17/Treg imbalance and clinical characteristics in psoriasis patients with metabolic dysfunction-associated steatotic liver disease: a cross-sectional analysis S D Sai Dong 1 † Z Q Zixuan Qiu 2 † Z Z Zheng Zhao 3 † H B Hui Bao 4 † X L Xiaoyang Liu 1 Z M Zhanglei Mu 1 J Z Jianzhong Zhang 1 H L Houmin Li 1 ‡ * B F Bo Feng 2 ‡ * L C Lin Cai 1 ‡ * 1. Department of Dermatology, Peking University People’s Hospital, Beijing, China 2. Department of Hepatology, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing, China 3. Department of Dermatology, Peking University International Hospital, Beijing, China 4. Health Management Center, Peking University People’s Hospital, Beijing, China See more Article metrics View details Abstract Background: Psoriasis is a chronic systemic inflammatory disease that imposes a considerable burden of metabolic comorbidities. Metabolic dysfunction-associated steatotic liver disease (MASLD) is particularly common among patients with psoriasis, which may be attributed to shared metabolic and immune-inflammatory pathogenic pathways. However, evidence linking peripheral T-cell profiles to clinical phenotypes remains limited. Methods: This is a cross-sectional study. A total of 408 participants were enrolled stratified into three groups: 206 patients with plaque psoriasis, 100 subjects undergoing routine health examinations (RHE group), and 102 patients with isolated MASLD. All participants underwent vibration-controlled transient elastography (VCTE) via FibroScan®, with simultaneous acquisition of Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP). Comprehensive clinical and laboratory data were collected for further analysis. In a subset of 49 psoriasis participants (32 patients with psoriasis and MASLD and 17 patients with psoriasis alone), peripheral T-cell subpopulations were quantified using flow cytometry. Results: Psoriasis patients had a higher MASLD prevalence than participants in RHE group (65.5% vs. 46.0%, P = 0.002), with psoriasis independently associated with MASLD (adjusted OR = 2.282, 95% CI: 1.181-4.408). Body mass index (BMI), hyperuricemia, insulin resistance-related indices (triglyceride glucose index [TyG], TyG-BMI), and uric acid-to-high-density lipoprotein cholesterol ratio (UHR) were linked to concomitant MASLD in psoriasis patients. Elevated liver enzymes were associated with severe hepatic steatosis grades. An exploratory model combining BMI, TyG and hyperuricemia exhibited favorable performance for MASLD screening, with an area under the receiver operating characteristic curve (AUC) of 0.84 (95% CI, 0.78-0.89). Compared with patients with psoriasis alone, those with coexisting MASLD showed elevated circulating IL-17+ Th17 cells and an increased Th17/Treg ratio, and this immune imbalance correlated positively with the grade of hepatic steatosis. Conclusion: Psoriasis is independently associated with MASLD. Psoriasis patients with coexisting MASLD present metabolic abnormalities along with peripheral Th17/Treg immune imbalance. The exploratory model combining BMI, the TyG index and hyperuricemia shows good performance for MASLD screening. These findings highlight the importance of multidisciplinary management for patients with psoriasis. Introduction Psoriasis is a chronic, immune-mediated, inflammatory skin disease with multi-organ involvement. It is often accompanied by multiple comorbidities, including psoriatic arthritis (PsA), metabolic syndrome (MetS), obesity, type 2 diabetes mellitus (T2DM), dyslipidemia, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease (MASLD), etc. MASLD, as the most prevalent chronic liver disease globally, exhibits significantly higher prevalence among psoriasis populations and aggravates systemic metabolic disturbance and chronic inflammatory burden. Several studies indicate that the prevalence of MASLD is significantly higher in psoriasis patients than in the general population (approximately 30%-50% vs. 20%-30%) ( 1 , 2 ). Metabolic-associated syndrome, characterized by obesity and insulin resistance, is recognized as a shared risk factor for both psoriasis and MASLD, which may account for the mechanistic overlap between the two disorders ( 3 – 6 ). Additionally, psoriasis and MASLD share overlapping immunoinflammatory pathogenic pathways driven by elevated tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, lowered circulating adiponectin and Th17/Treg imbalance ( 7 – 10 ). Although previous studies have described the epidemiological association between psoriasis and MASLD, most reports focus merely on clinical correlation or single inflammatory markers. Comprehensive profiling of circulating Th1, Th17, and Treg and their relationship with clinical and hepatic phenotypes remains scarce. Therefore, the present cross-sectional study systematically compared clinical, metabolic, and hepatic characteristics between psoriasis patients with and without MASLD. Furthermore, we detected peripheral immune indices in a subgroup to clarify alterations in Th17/Treg immune profiles. This study aimed to reveal the potential immunological mechanism underlying psoriasis-MASLD comorbidity and provide novel inflammatory biomarkers for early screening and stratified clinical management of high-risk psoriasis populations. Materials and methods Study design and ethical approval This cross-sectional analysis was performed based on baseline data derived from a prospective study. All psoriasis patients were administered standardized treatment with regular follow-up. This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Peking University People’s Hospital (2025PHB194-001). All enrolled participants were divided into three groups: patients with plaque psoriasis, MASLD patients without psoriasis, and subjects undergoing routine health examinations (RHE). All participants provided written informed consent prior to study enrollment. Sample size calculation Sample size calculation was performed using PASS version 25.0.3 (NCSS, LLC, Kaysville, UT, USA). Based on previously reported MASLD prevalence rates of 44% in psoriasis patients and 25% in the general population ( 11 ), we designed this study with a 2:1 enrollment ratio of psoriasis patients to RHE participants and a 10% dropout allowance. With a two-sided α of 0.05 and 85% statistical power, the two-sample unequal proportion test indicated a minimum sample of 278 participants, including 185 psoriasis patients and 93 routine health-examination subjects. Given the 44% comorbidity rate of MASLD among psoriasis patients, an additional isolated MASLD group was enrolled, forming a 2:1:1 enrollment ratio among psoriasis group, RHE group, and isolated MASLD group. Study population and data collection The study enrolled adult psoriasis patients from Department of Dermatology, Peking University People’s Hospital between April 2025 and February 2026. Participants in the RHE group were recruited from the hospital’s Health Management Center, and patients with isolated MASLD were enrolled from the Department of Hepatology during the same period. Drug-induced liver injury, viral hepatitis, immune-mediated liver disease, or excessive alcohol consumption (ethanol intake ≥210 g/week for men and ≥140 g/week for women) were excluded based on medication history, liver biochemical tests, viral hepatitis screening, autoimmune-related laboratory findings, and other relevant clinical information. Diagnostic criteria for MASLD includes steatotic liver disease confirmed by FibroScan® and at least one of five cardiometabolic criteria ( 12 ). All MASLD diagnoses were confirmed by hepatologists. Participants in the RHE group were frequency-matched to psoriasis group by sex, with the sex distribution observed in the psoriasis group (approximate male-to-female ratio of 6:4). Patients with isolated MASLD were frequency-matched to PsO-MASLD patients by sex (approximate male-to-female ratio of 6:4) and CAP-defined hepatic steatosis grade (approximate mild-to-moderate-to-severe distribution of 2:3:5). Detailed diagnostic, inclusion and exclusion criteria are provided in the Supplementary Materials . Clinical data were collected, including demographic information (age, sex, and body mass index [BMI]), clinical profiles (history of MetS, T2DM, hypertension, and hyperuricemia, as well as alcohol consumption status, etc.), psoriasis-related indicators (Psoriasis Area and Severity Index [PASI], Body Surface Area [BSA], static Physician Global Assessment [sPGA], etc.) and laboratory parameters. Two insulin resistance indices, namely the triglyceride-glucose (TyG) index and TyG-BMI, were calculated using the following formulas: TyG=ln [triglyceride (mg/dL)×fasting blood glucose (mg/dL)/2]; TyG-BMI = TyG×BMI (kg/m2). Liver assessment Liver steatosis, quantified by the controlled attenuation parameter (CAP) and hepatic fibrosis, quantified by liver stiffness measurement (LSM), were assessed using vibration-controlled transient elastography (VCTE) with a FibroScan® device (Echosens, Paris, France). Examinations were performed after overnight fasting, with participants lying in the supine position and their right arm placed behind the head. The probe was placed over the right hepatic lobe through an intercostal space. The M or XL probe was selected according to the manufacturer’s recommendation. At least 10 valid measurements were obtained at the same site using the same probe. The median values of valid measurements were used for subsequent analyses and measurements were considered reliable when IQR/median ≤30%. All examinations were performed by trained sonographers. The grade of steatosis was defined based on CAP value according to the center's criteria: mild steatosis (238-259dB/m), moderate steatosis (259-292dB/m), and severe steatosis (≥292 dB/m). Fibrosis status was assessed using LSM value, with significant fibrosis defined as LSM ≥8 kPa ( 12 ). Flow cytometry A consecutive subset of 49 patients with psoriasis underwent immune profiling by flow cytometry. Fresh peripheral whole blood samples were collected and processed within 24 hours of collection. Flow cytometry was applied to quantify the proportions of multiple CD4 + T cell subsets, including interferon (IFN)-γ + (CD3+CD4+IFN+), TNF-α + (CD3+CD4+ TNF-α+), and IL-2 + Th1-related cells (CD3+CD4+IL-2+), IL-4 + Th2 cells (CD3+CD4+IL-4+), IL-17A + Th17 cells (CD3+CD4+IL-17A+), and regulatory T (Treg) cells (CD3+CD4+CD25highFoxp3+). For intracellular cytokine analysis, heparinized blood was stimulated by using Leukocyte Activation Cocktail and BD GolgiPlugTM (4 hours, 37 °C). Cells were surface-stained with anti-CD3-PerCP and anti-CD4-APC antibodies, fixed and permeabilized with the BD IntraSureTM Kit. Then cells were stained intracellularly with anti-IL-2-FITC, anti-TNF-α-PE, anti-IFN-γ-FITC, anti-IL-4-PE, and anti-IL-17A-PE antibodies (all from BD Biosciences). Detailed information on antibody clones is provided in Supplementary Table S1 . For Treg analysis, EDTA-anticoagulated cells were surface-stained with anti-CD3-PerCP, anti-CD4-APC and anti-CD25-PE antibodies (all from BD Biosciences). After fixation and permeabilization, cells were stained with anti-FoxP3-AF647 antibody (from BioLegend). Samples for Treg analysis was acquired using a BD FACSLyric flow cytometer (BD Biosciences), whereas samples for Th1, Th2, and Th17 analysis were acquired using a BriCyte E6 flow cytometer (Mindray). Data were analyzed using MRFlow software (Mindray, Shenzhen, China) and BD FACSDiva software (BD Biosciences, San Jose, CA, USA). All the lymphocyte population was identified on the basis of forward scatter (FSC) and side scatter (SSC) characteristics. Gating strategies are provided in Supplementary Figure 1 . Statistical analysis All statistical analyses were performed using IBM SPSS Statistics version 27.0 (IBM Corp., Armonk, NY, USA) or GraphPad Prism version 10.6 (GraphPad software, LLC, San Diego, CA, USA). Continuous variables were presented as mean ± standard deviation (SD) or median with interquartile range (IQR). Categorical data were shown as numbers and percentage. The student’s t-test or Mann-Whitney U test were used for quantitative comparisons according to data distribution. The chi-squared test or Fisher’s exact test was used for categorical comparisons. Univariate logistic regression, multivariate logistic regression and multiple linear regression were used to identify independent factors associated with MASLD. Results are presented as odds ratios (OR) and 95% confidence intervals (CI). Furthermore, the area under the curve (AUC), the specificity and the sensitivity were calculated to evaluate model discriminatory performance. Spearman’s rank correlation analysis was used to evaluate the associations of Th17 cells and the Th17/Treg ratio with PASI, BSA, CAP, and CAP-stratified hepatic steatosis grades. The Benjamini-Hochberg false discovery rate (BH-FDR) procedure was applied to the between-group comparisons of immune profiles. A P-value 420mmol/L in men and >360 mmol/L in women. TC, total cholesterol; HDL, high-density lipoprotein cholesteroPLR, platelet-to-lymphocyte ratio; SII, systemic immune-inflammation index; UHR, uric acid-to-HDL ratio. * P<0.05, **P<0.01, ***P<0.001 Table 2 Variables PsO-MASLD MASLD P value N=135 N=102 Age (years) 41.69 ± 14.31 42.70 ± 11.02 0.541 Sex (male) 86 (63.7%) 68 (66.7%) 0.737 Height (cm) 169.46 ± 8.23 170.15 ± 7.47 0.510 Weight (kg) 75.83 ± 13.17 79.92 ± 14.23 0.023* BMI (kg/m 2 ) 26.31 ± 3.53 27.54 ± 4.26 0.016* Underweight (<18.5) 2 (1.5%) 0 (0.0%) 0.508 Normal weight (18.5-24) 28 (20.7%) 18 (17.6%) 0.667 Overweight (24-28) 64 (47.4%) 45 (44.1%) 0.710 Obesity (≥28) 41 (30.4%) 39 (38.2%) 0.259 Liver assessment LSM (kPa) 5.00 (4.25, 5.80) 5.40 (4.50, 6.67) 0.011* CAP (dB/m) 289.00 (266.00, 326.00) 301.32 ± 40.68 0.278 MASLD Mild steatosis 28 (20.7%) 16 (15.7%) 0.411 Moderate steatosis 44 (32.6%) 31 (30.4%) 0.826 Severe steatosis 63 (46.7%) 55 (53.9%) 0.330 Comorbidities Hypertension 13 (9.6%) 22 (21.6%) 0.017* Hyperlipidemia 46 (34.1%) 53 (52.0%) 0.009** Cardiovascular disease 2 (1.5%) 4 (3.9%) 0.407 Diabetes mellitus 10 (7.4%) 13 (12.7%) 0.249 Hyperuricemia 62 (45.9%) 48 (47.1%) 0.967 MetS 23 (17.0%) 21 (20.6%) 0.598 Laboratory parameters Blood routine Neutrophil (10 9 /L) 4.10 (3.31, 5.12) 3.58 (3.05, 4.62) 0.021* Lymphocyte (10 9 /L) 2.13 (1.81, 2.68) 2.20 ± 0.68 0.751 Monocyte (10 9 /L) 0.38 (0.32, 0.46) 0.40 (0.29, 0.50) 0.963 Eosinophil (10 9 /L) 0.12 (0.07, 0.19) 0.13 (0.07, 0.21) 0.637 Basophil (10 9 /L) 0.03 (0.02, 0.04) 0.03 (0.02, 0.04) 0.295 Platelet (10 9 /L) 257.13 ± 65.61 251.70 ± 56.18 0.503 Blood Biochemistry Uric acid (umol/L) 386.18 ± 103.90 393.40 ± 91.38 0.577 Blood glucose (mmol/L) 4.96 (4.69, 5.70) 5.11 (4.69, 5.63) 0.464 TC (mmol/L) 4.98 ± 0.91 4.88 ± 1.13 0.501 TG (mmol/L) 1.54 (1.12, 2.39) 1.62 (1.23, 2.46) 0.206 HDL (mmol/L) 1.09 (0.97, 1.25) 1.15 ± 0.22 0.317 LDL (mmol/L) 3.09 ± 0.70 3.07 ± 0.82 0.836 ALT (U/L) 25.00 (17.00, 45.50) 42.00 (26.25, 79.75) <0.001*** AST (U/L) 23.00 (18.00, 30.00) 28.50 (23.00, 42.00) <0.001*** γ-GT (U/L
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