Fig. 4

Evidence of altered CD4 + T cell plasticity in post-treatment samples from patients with polyJIA. A Naïve CD4 + T cells differentiate into numerous effector subsets and can become Th17 cells implicated in autoimmunity. One model of CD4 + T cell plasticity proposes transdifferentiation of homeostatic Th17 cells into pathogenic IFNγ-expressing Th17/1 cells or ex-Th17 cells. PBMCs were left unstimulated or stimulated overnight with PMA + calcimycin and CD3 + CD4 + T cells analyzed for cytokine production. Cells were additionally surface stained with CCR6 and CD161 to identify transitioned cells. B Treatment-naïve (TN) polyJIA patients had detectable Th17/1 cells, but Th17/1 cells were significantly higher in post-treatment (PT) samples (TN 0.07 ± 0.02% v PT 0.3 ± 0.1%, *p < 0.05, Wilcoxon matched-pairs signed rank test). C There were more previously IL-17 expressing ex-Th17 cells in samples from post-treatment polyJIA patients than in the same patients when treatment-naïve (TN 1.4 ± 0.4% v PT 2.3 ± 0.5%, *p < 0.05, Wilcoxon matched-pairs signed rank test). Black bars represent mean ± SEM. PBMCs, peripheral blood mononuclear cells, PMA, phorbol 12-myristate 13-acetate; IFN, interferon, IL, interleukin