The influence of regulatory T cells and diurnal hormone rhythms on T helper cell activity

Symptoms of diseases such as rheumatoid arthritis, which is T helper 1 (Th1) dependent, and asthma, which is T helper 2 (Th2) dependent, are influenced by diurnal rhythms and natural regulatory T cells (nTreg). However, the mechanisms responsible for the diurnal rhythm of disease activity have not been identified and it is unclear whether nTreg activity is diurnal rhythm‐dependent. We therefore investigated whether a 24‐hr diurnal cycle affected the ability of various helper T‐cell populations to generate immunomodulatory and pro‐inflammatory cytokines, as well as its suppression by nTreg cells. Using a within‐subject crossover design, sleep versus continuous wakefulness was compared over a 24‐hr period in healthy young volunteers under defined environmental conditions. Venous blood was drawn periodically every 5 hr and the function of T cells was explored in vitro. We demonstrated that interleukin (IL)‐2, interferon‐γ (IFN‐γ), tumour necrosis factor‐α (TNF‐α) and IL‐10 secretion by naïve CD4⁺ T cells follows a diurnal rhythm. Furthermore, multiple regression analysis, as well as subsequent in vitro experiments, suggested that serum levels of cortisol and prolactin are part of the underlying mechanism. Additionally, we observed that nTreg suppressed the secretion of IFN‐γ, IL‐2 and TNF‐α, but not the secretion of IL‐4, IL‐6, IL‐10 and IL‐17A. However, the abrogation of IL‐2 release was reversed upon inhibiting CD25 on nTreg. Highly purified nTreg secreted IL‐6, IL‐10 and IL‐17A, but not IL‐2, IL‐4, IFN‐γ or TNF‐α. Taken together, our results demonstrate that hormones and nTreg modulate the diurnal rhythm of T helper cell activity.