Th1/Th17-Treg Imbalance in Asian Atrial Fibrillation

Figure 1. Th-Cell Ratios across Control and Atrial Fibrillation Groups Data analysis was performed on the full cohort (n = 260). P values were derived from Kruskal-Wallis tests with false discovery rate (FDR)-corrected Dunn's post hoc analysis. ∗P < 0.05, ∗∗P < 0.01, ∗∗∗P < 0.001 vs control after FDR correction. Both atrial fibrillation subtypes showed significantly higher Th1 and Th17 cells and increased Th1/Th2, Th1/Treg, and Th17/Treg ratios versus controls, with the Th1/Th2 ratio increase more pronounced in PerAF than ParAF. ParAF = paroxysmal atrial fibrillation; PerAF, persistent atrial fibrillation; Th = T helper; Treg = T regulatory cell.

Figure 2. Cytokines Across Control and Atrial Fibrillation Groups Data analysis was performed on the subgroup(n = 98). P values were derived from Kruskal-Wallis tests with FDR-corrected Dunn's post hoc analysis. ∗P < 0.05, ∗∗P < 0.01, ∗∗∗P < 0.001 vs control after FDR correction. Interleukin (IL)-6 and high-sensitivity C-reactive protein concentrations showed a progressive increase across atrial fibrillation subtypes, with significantly higher levels in the total atrial fibrillation group vs controls. IFN = interferon; other abbreviations as in Figure 1.

Figure 3. Correlation Analysis Between Left Atrial Diameter and Key T Lymphocyte Parameters Spearman correlation analysis was performed on the full cohort (n = 260). q values were calculated using the Benjamini-Hochberg procedure for all 9 correlations presented in this figure as a single family. After FDR correction, left atrial diameter showed significant positive correlations with Th1/Treg ratio, Th1/Th2 ratio, Th17/Treg ratio, Th1%, Th1 count, and Th17%; no significant correlations were observed with Treg cells. Abbreviations as in Figures 1 and 2.

Figure 4. Correlations Between Th1/IFN-γ and IL-6/Th17/IL-17A Variables Correlation analysis was performed on the cytokine subsample (n = 98). q values were calculated using the Benjamini-Hochberg procedure for all 6 correlations presented in this figure as a single family. After FDR correction, significant correlations were observed between Th17/Treg ratio and IL-17A and between Th17% and IL-17A; all other correlations between T-cell subsets and effector cytokines were not significant. LAD = left atrial diameter; other abbreviations as in Figures 1 and 2.

Central Illustration. Peripheral T Helper 1/T Helper 17‒T Regulatory Cell Imbalance in Atrial Fibrillation Asian patients with atrial fibrillation (AF) exhibit dysregulation of adaptive immunity in peripheral blood, characterized by elevated T helper (Th)17 counts and an increased Th1/T regulatory cell (Treg) ratio. Immunological alterations are more extensive in paroxysmal atrial fibrillation (ParAF), whereas persistent atrial fibrillation (PerAF) demonstrates a more selective Th1/Treg imbalance.