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Th1-Th2 Balance

Immunology · NLM MeSH · updated 2026-10-29 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 5 min read

Homeostatic control of the immune system by different cytokines that induce the differentiation of helper t-cells into TH1 and th2 cells and result in a balance or imbalance (leading to disease) of Th1 and Th2 cells' immune respon

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (876 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

Homeostatic control of the immune system by different cytokines that induce the differentiation of helper t-cells into TH1 and th2 cells and result in a balance or imbalance (leading to disease) of Th1 and Th2 cells' immune responses.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Balance, Th1-Th2; Th1 Th2 Balance; Th1-Th2 Cytokine Balance; Cytokine Balances, Th1-Th2; Cytokine Balance, Th1-Th2; Th1 Th2 Cytokine Balance; Th1-Th2 Cytokine Balances.

Where it fits in the MeSH classification

Broader topics
Immune System Phenomena
See also
CD4 Lymphocyte Count

Related concepts

  • Immune System
  • Cytokines
  • Helper T-Cells
  • Th2 Cells

Research landscape

PubMed indexes 1,126 records tagged with the MeSH heading “Th1-Th2 Balance” (counts retrieved 2026-10-29). 172 of them (15.3%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 950 records.

Reviews account for 173 records (15.4%) and meta-analyses for 3. Randomized controlled trials number 34 (3.0%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 0 records; 2000-2009: 13 records; 2010-2019: 950 records; 2020 onward: 172 records0through 1999132000-20099502010-20191722020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19990
2000-200913
2010-2019950
2020 onward172
Share of records by publication typeReviews: 15.4 percent; Meta-analyses: 0.3 percent; Randomized controlled trials: 3.0 percentReviews15.4% (173)Meta-analyses0.3% (3)Randomized controlled trials3.0% (34)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 1,126 PubMed records
TypeRecordsShare
Reviews17315.4%
Meta-analyses30.3%
Randomized controlled trials343.0%

Method: PubMed query "Th1-Th2 Balance"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.

Reading the evidence in immunology

Immune responses are studied in model organisms, in cells from donors and in patients, and the same pathway can behave differently across these settings. Mouse immune systems differ from human ones in important ways, and blood measurements may not reflect what happens in tissues. Clinical conclusions about immune-mediated disease or immunotherapy come mainly from controlled trials and long-term cohorts. Check the species and tissue studied, whether markers were linked to outcomes patients notice, and the follow-up time.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Inflammatory cytokines and change of Th1/Th2 balance as prognostic indicators for hepatocellular carcinoma in patients treated with transarterial chemoembolization
Lee HL, Jang JW, Lee SW, Yoo SH, Kwon JH, Nam SW, et al.
2019Research article
Design not recorded in structured metadata
146cc by
PMID 30824840 · DOI · PMC6397294
TH1/TH2 Cytokine profile in relapsing-remitting multiple sclerosis patients treated with Glatiramer acetate or Natalizumab
Oreja-Guevara C, Ramos-Cejudo J, Aroeira LS, Chamorro B, Diez-Tejedor E
2012Research article
Design not recorded in structured metadata
110cc by
PMID 22989378 · DOI · PMC3517482
EGCG Maintains Th1/Th2 Balance and Mitigates Ulcerative Colitis Induced by Dextran Sulfate Sodium through TLR4/MyD88/NF-κB Signaling Pathway in Rats
Bing X, Xuelei L, Wanwei D, Linlang L, Keyan C
2017Research article
Design not recorded in structured metadata
85cc by
PMID 29404307 · DOI · PMC5748319
Bioprocessed Black Rice Bran and Balloon Flower Root Cooperatively Regulate IgE, Epithelial Signaling, and Th1/Th2 Balance to Induce Therapeutic Response in a Mouse Model of Atopic Dermatitis
Lee KH, Kwon KS, Hwang WS, Friedman AD, Lee WY, Kim J, et al.
2026Research article
Design not recorded in structured metadata
0cc by
PMID 41898552 · DOI · PMC13027177

Inflammatory cytokines and change of Th1/Th2 balance as prognostic indicators for hepatocellular carcinoma in patients treated with transarterial chemoembolization [1]

Research article Lee HL, Jang JW, Lee SW, Yoo SH, Kwon JH, Nam SW, et al. · · 2019 · cited 146 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Tumor-associated immune response plays a critical role in cancer pathogenesis.
Closing excerpt
A shift toward increased Th1 response and no increase in IL-6 level exert favorable immunologic effects on HCC prognosis.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (198 words)

Tumor-associated immune response plays a critical role in cancer pathogenesis. This study evaluated clinical implications of T cell cytokines and regulatory T cells (Tregs) in HCC patients treated with TACE. Whole blood was obtained for analysis of T cell cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-17A, IL-22, IFN-γ, and TNF-α) and Tregs from 142 HCC patients. Patients with CTP class A had a significantly lower proportion of detectable IL-4 or IL-6, but a higher proportion of detectable IL-22 than patients with CTP class B/C. IL-6 level was well correlated with tumor stage and undetectable IL-17A was associated with extrahepatic metastasis. The overall survival rate was significantly higher in patients who had undetectable IL-6 or detectable IL-22 than patients who did not. IL-6 among cytokines remained independently predictive factor for survival. Increased IFN-γ/IL-10 ratio and no increase in IL-6 level following TACE were associated with prolonged survival, and baseline Tregs could affect Th1/Th2 balance. T cell cytokines are associated with a variety of clinical aspects of HCC, and IL-6 is the most significant predictor of survival. A shift toward increased Th1 response and no increase in IL-6 level exert favorable immunologic effects on HCC prognosis.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30824840 · DOI · PMC6397294

TH1/TH2 Cytokine profile in relapsing-remitting multiple sclerosis patients treated with Glatiramer acetate or Natalizumab [2]

Research article Oreja-Guevara C, Ramos-Cejudo J, Aroeira LS, Chamorro B, Diez-Tejedor E · · 2012 · cited 110 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundThe balance between T helper cells Th2- and Th1-related cytokines plays a key role in multiple sclerosis (MS).
Closing excerpt
Future studies with larger cohorts will determine whether this immune Th2 shift in GA patients is associated with a beneficial effect on disease outcome.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (236 words)

BackgroundThe balance between T helper cells Th2- and Th1-related cytokines plays a key role in multiple sclerosis (MS). A shift from a Th1 towards a Th2 cytokine profile could have a beneficial effect on the clinical course of the disease. The objective of this study was to assess Th2/Th1 cytokine profile in relapsing-remitting MS (RRMS) patients receiving an immunosuppressive treatment with natalizumab (NAT), or an immunomodulatory treatment with glatiramer acetate (GA) after one year of treatment.MethodsThis was an observational cross-sectional study. All consecutive patients diagnosed with RRMS who had received GA or NAT for 12 months were included in the study. We determined serum levels of Th1 and Th2 cytokines (interleukin [IL]-1a, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, monocyte chemotactic protein [MCP]-1, tumor-necrosis factor [TNF]-α, interferon [IFN]-γ and granulocyte macrophage colony stimulating factor [GM-CSF]) by flow cytometry. Th2/Th1 bias was defined based on the ratio of IL-4, IL-5, IL-6 or IL-10 Th2 cytokines and proinflammatory INF-γ or TNF-α Th1 cytokines.ResultsEleven patients under treatment with NAT and 12 patients treated with GA were evaluated. RRMS patients treated with NAT showed significantly higher levels of IL-6 (p ConclusionIn conclusion, our findings suggest that GA promotes a superior Th2-biased anti-inflammatory response as compared with NAT in the systemic circulation of RRMS patients. Future studies with larger cohorts will determine whether this immune Th2 shift in GA patients is associated with a beneficial effect on disease outcome.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 22989378 · DOI · PMC3517482

EGCG Maintains Th1/Th2 Balance and Mitigates Ulcerative Colitis Induced by Dextran Sulfate Sodium through TLR4/MyD88/NF-κB Signaling Pathway in Rats [3]

Research article Bing X, Xuelei L, Wanwei D, Linlang L, Keyan C · · 2017 · cited 85 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
ObjectiveTo observe the protective effect of epigallocatechin gallate (EGCG) on dextran sulfate sodium- (DSS-) induced ulcerative colitis in rats and to explore the roles of TLR4/MyD88/NF-κB signaling pathway.
Closing excerpt
ConclusionEGCG can inhibit the intestinal inflammatory response by reducing the severity of ulcerative colitis and maintaining the Th1/Th2 balance through the TLR4/MyD88/NF-κB signaling pathway.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (192 words)

ObjectiveTo observe the protective effect of epigallocatechin gallate (EGCG) on dextran sulfate sodium- (DSS-) induced ulcerative colitis in rats and to explore the roles of TLR4/MyD88/NF-κB signaling pathway.MethodsRat models of ulcerative colitis were established by giving DSS. EGCG (50 mg/kg/d) was given to assess disease activity index. HE staining was applied to observe histological changes. ELISA and qPCR detected the expression of inflammatory factors. Flow cytometry was used to measure the percentage of CD4+IFN-γ+ and CD4+IL-4+ in the spleen and colon. TLR4 antagonist E5564 was given in each group. Flow cytometry was utilized to detect CD4+IFN-γ+ and CD4+IL-4+ cells. Immunohistochemistry, qPCR, and western blot assay were applied to measure the expression of TLR4, MyD88, and NF-κB.ResultsEGCG improved the intestinal mucosal injury in rats, inhibited production of inflammatory factors, maintained the balance of Th1/Th2, and reduced the expression of TLR4, MyD88, and NF-κB. After TLR4 antagonism, the protective effect of EGCG on intestinal mucosal injury was weakened in rats with ulcerative colitis, and the expressions of inflammatory factors were upregulated.ConclusionEGCG can inhibit the intestinal inflammatory response by reducing the severity of ulcerative colitis and maintaining the Th1/Th2 balance through the TLR4/MyD88/NF-κB signaling pathway.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29404307 · DOI · PMC5748319

Bioprocessed Black Rice Bran and Balloon Flower Root Cooperatively Regulate IgE, Epithelial Signaling, and Th1/Th2 Balance to Induce Therapeutic Response in a Mouse Model of Atopic Dermatitis [4]

Research article Lee KH, Kwon KS, Hwang WS, Friedman AD, Lee WY, Kim J, et al. · · 2026

Abstract reading summary — source excerpts
Opening excerpt
Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by epidermal barrier dysfunction and dysregulated immune responses, particularly an imbalance between T helper type 1 (Th1) and type 2 (Th2) cytokines.
Closing excerpt
These findings indicate that BRB-F and BFR-F modulate multiple immune pathways and help restore Th1/Th2 immune balance, suggesting their potential as functional materials for regulating immune dysregulation associated with AD.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (250 words)

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by epidermal barrier dysfunction and dysregulated immune responses, particularly an imbalance between T helper type 1 (Th1) and type 2 (Th2) cytokines. Natural products with immunomodulatory activity have attracted increasing attention as potential strategies for regulating allergic inflammation. In this study, we investigated the immunomodulatory effects of bioprocessed black rice bran (BRB-F) and bioprocessed balloon flower root (BFR-F). In vitro assays using human B cells, mast cells, and keratinocytes were conducted to evaluate IgE production, mast cell degranulation, and epithelial inflammatory mediator release. The efficacy of the BRB-F:BFR-F mixture was further evaluated in BALB/c mice with 2,4-dinitrochlorobenzene (DNCB)/Dermatophagoides farinae extract (DFE)-induced AD-like dermatitis. BRB-F and BFR-F suppressed IgE production, attenuated mast cell degranulation and thymic stromal lymphopoietin (TSLP) release, and reduced keratinocyte-derived inflammatory mediators (thymus and activation-regulated chemokine (TARC), macrophage-derived chemokine (MDC), and IL-6). In mice, dietary supplementation with the BRB-F:BFR-F mixture (10-80 mg/kg/day) dose-dependently improved clinical skin lesions and histopathological changes, with serum IgE reduced by up to 87.1% at the highest dose. The treatment significantly suppressed Th2 cytokine mRNA expression in ear tissue (IL-4, IL-5, and IL-13) by 37.2%, 32.7%, and 34.0%, respectively, compared with the positive control. In contrast, splenic Th1 cytokine mRNA expression (IL-2, IL-12, and IFN-γ) was partially restored by 37.1%, 22.5%, and 18.7%, respectively. These findings indicate that BRB-F and BFR-F modulate multiple immune pathways and help restore Th1/Th2 immune balance, suggesting their potential as functional materials for regulating immune dysregulation associated with AD.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41898552 · DOI · PMC13027177

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Sex hormones and autoimmunity [5]
    González DA, Díaz BB, Rodríguez Pérez Mdel C, Hernández AG, Chico BN, de León AC · Immunol Lett · 2010 · cited 101 times (Europe PMC)
  • Research article Retinoic acid: a key player in immunity [6]
    Pino-Lagos K, Guo Y, Noelle RJ · Biofactors · 2010 · cited 82 times (Europe PMC)
  • Research article A systematic review on the functional role of Th1/Th2 cytokines in type 2 diabetes and related metabolic complications [7]
    Mahlangu T, Dludla PV, Nyambuya TM, Mxinwa V, Mazibuko-Mbeje SE, Cirilli I, et al. · Cytokine · 2020 · cited 74 times (Europe PMC)
  • Research article The balance of the immune system between T cells and NK cells in miscarriage [8]
    Nakashima A, Shima T, Inada K, Ito M, Saito S · Am J Reprod Immunol · 2012 · cited 66 times (Europe PMC)
  • Research article Immune modulation for treatment of allergic disease [9]
    Nguyen TH, Casale TB · Immunol Rev · 2011 · cited 63 times (Europe PMC)
  • Research article Th subset balance in lupus nephritis [10]
    Miyake K, Akahoshi M, Nakashima H · J Biomed Biotechnol · 2011 · cited 55 times (Europe PMC)

References

  1. Lee HL, Jang JW, Lee SW, Yoo SH, Kwon JH, Nam SW, et al.. Inflammatory cytokines and change of Th1/Th2 balance as prognostic indicators for hepatocellular carcinoma in patients treated with transarterial chemoembolization. . 2019. PMID 30824840 · DOI · PMC6397294
  2. Oreja-Guevara C, Ramos-Cejudo J, Aroeira LS, Chamorro B, Diez-Tejedor E. TH1/TH2 Cytokine profile in relapsing-remitting multiple sclerosis patients treated with Glatiramer acetate or Natalizumab. . 2012. PMID 22989378 · DOI · PMC3517482
  3. Bing X, Xuelei L, Wanwei D, Linlang L, Keyan C. EGCG Maintains Th1/Th2 Balance and Mitigates Ulcerative Colitis Induced by Dextran Sulfate Sodium through TLR4/MyD88/NF-κB Signaling Pathway in Rats. . 2017. PMID 29404307 · DOI · PMC5748319
  4. Lee KH, Kwon KS, Hwang WS, Friedman AD, Lee WY, Kim J, et al.. Bioprocessed Black Rice Bran and Balloon Flower Root Cooperatively Regulate IgE, Epithelial Signaling, and Th1/Th2 Balance to Induce Therapeutic Response in a Mouse Model of Atopic Dermatitis. . 2026. PMID 41898552 · DOI · PMC13027177
  5. González DA, Díaz BB, Rodríguez Pérez Mdel C, Hernández AG, Chico BN, de León AC. Sex hormones and autoimmunity. Immunol Lett. 2010. PMID 20637236 · DOI
  6. Pino-Lagos K, Guo Y, Noelle RJ. Retinoic acid: a key player in immunity. Biofactors. 2010. PMID 20803520 · DOI · PMC3826167
  7. Mahlangu T, Dludla PV, Nyambuya TM, Mxinwa V, Mazibuko-Mbeje SE, Cirilli I, et al.. A systematic review on the functional role of Th1/Th2 cytokines in type 2 diabetes and related metabolic complications. Cytokine. 2020. PMID 31704479 · DOI
  8. Nakashima A, Shima T, Inada K, Ito M, Saito S. The balance of the immune system between T cells and NK cells in miscarriage. Am J Reprod Immunol. 2012. PMID 22364212 · DOI
  9. Nguyen TH, Casale TB. Immune modulation for treatment of allergic disease. Immunol Rev. 2011. PMID 21682751 · DOI
  10. Miyake K, Akahoshi M, Nakashima H. Th subset balance in lupus nephritis. J Biomed Biotechnol. 2011. PMID 21904445 · DOI · PMC3163408

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-29.

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At a glance

1,126
PubMed records on this heading
15%
published since 2020
173
review articles
34
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-29; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Immune SystemAnatomy and Physiology
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