CCR6 is preferentially expressed on Th17 cells 9; however, CCR6 expression was not studied on the combinatorial subsets of IL-17A- and IL-22-secreting CD4+ T Lenvatinib datasheet cells. Since CCR6 is extensively downmodulated by T-cell stimulation, we purified CCR6+ and CCR6−

lymphocytes (Supporting Information Fig. S2D) before stimulation and intracellular cytokine detection. We observed that CCR6 is indeed more frequently expressed on IL-17A-secreting CD4+ T cells as compared with both IL-22- and IFN-γ-secreting CD4+ T cells (Supporting Information Fig. S2E). Of note, CCR6 is expressed at similar levels on IL-17A+IL-22− cells and IL-17A+IL-22+ cells, although a trend toward a modest decline in CCR6 expression is observed on the latter (Supporting Information Fig. S2F). Moreover, CCR6 expression was not associated with CD161 expression, since CCR6 levels are similar on CD161+ and CD161− IL-17A- and/or IL-22-secreting CD4+ T cells (Supporting

Metformin manufacturer Information Fig. S2G). IL-22+ CD4+ T cells from both controls and psoriasis patients co-secrete TNF-α and IL-2 in larger proportions than IL-17A+IL-22− CD4+ T cells, irrespective of their IL-17A status (Fig. 1C), thus demonstrating that co-secretion of the latter cytokines is associated with IL-22 rather than with IL-17A secretion. Of note, IFN-γ and IL-17A/IL-22 secretion are almost mutually exclusive. We conclude that IL-22-secreting CD4+ T cells are more polyfunctional than IL-17A+IL-22− cells, and that CD161 and CCR6 expression is a preferential feature of IL-17A-secreting CD4+ T cells irrespective of their IL-22 status. Unlike other Th subsets, the putative Th22 subset has as yet no unique transcription factor assigned to it and has been characterized only by Carnitine dehydrogenase its capacity to produce IL-22 in the absence of IL-17. Therefore, we applied multiparametric flow cytometry analysis to objectively determine whether this IL-22-secreting population represents an individualized subset. We used fluorescence intensity values extracted from ex vivo flow cytometry data files (Figs. 1 and 2A). This

enabled us to evaluate the IFN-γ, IL-17A and IL-22 cytokine secretion patterns of thousands of single-cell events and to order these patterns according to a distance tree obtained through hierarchical cluster analysis (Fig. 2B). In the dendrogram plot obtained, the largest distance change occurs between the third and fourth junctions, which corresponds to four major parallel branches leading to four individual clusters. Cells mainly secreting IFN-γ, IL-17A or IL-22 are grouped into three separate clusters, coined Th1, Th17 or Th22 respectively, whereas cells secreting none or only low levels of these three cytokines were grouped into a fourth cluster (Fig. 2C). Using three parameters, a maximum of eight (23) possible clusters could have been expected.