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Peer-reviewedCC BYFrontiers in immunology

The effect of low-temperature-induced immune activation in elderly idiopathic facial palsy: the association between Th1/Th2 imbalance and facial nerve inflammation

  • Xing Tang1
  • Ziqin Ji2
  • Xueling Xiao3
  • Tongtong Zhu4
  • Shoujen Lan5
  • Yeayin Yen5
  • Xin Shao6
  • Shune Tan6
  • Chao Wang3
  • Jicheng Zhang6
6 affiliations
  1. 1Department of Traditional Chinese Medicine Rehabilitation, Chongqing Emergency Medical Center , ,
  2. 2Medical College, Jiangsu University , , ,
  3. 3Sub-health Clinical Medicine Research Center, Sichuan Integrative Medicine Hospital , ,
  4. 4College of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine , ,
  5. 5Department of Healthcare Administration, Asia University , ,
  6. 6Department of Acupuncture, Sichuan Integrative Medicine Hospital , ,
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Abstract

The pathogenesis of idiopathic facial palsy in the elderly has not been fully elucidated. Recent studies have shown that exposure to low temperatures may participate in the pathological process through immune-mediated pathways. This article reviews that cold stimulation can disrupt the Th1/Th2 immune balance, manifested as reduced secretion of Th1-type cytokines and upregulation of Th2-type cytokines, thereby inducing peripheral inflammatory responses around the facial nerve, leading to nerve edema, demyelination, and conduction dysfunction. Due to the immune aging characteristics of the elderly population, including the reduction of the initial T cell pool, the imbalance of pro-inflammatory and anti-inflammatory factor ratios, and the decline in regulatory T cell function, they are more sensitive to the immune dysregulation induced by low temperatures and have a significantly increased risk of facial palsy. Clinical and animal experimental evidence supports this mechanism, suggesting that the serum IL-4/IFN-γ ratio may serve as a prognostic marker. Future multi-center studies are needed to verify the effectiveness of targeted immune regulation intervention through the Th2 pathway and explore the application value of low-temperature warning and individualized warming strategies in the prevention of facial palsy in the elderly.

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Cite

BibTeXRIS
BibTeX
@article{tang2026effect,
  title = {{The effect of low-temperature-induced immune activation in elderly idiopathic facial palsy: the association between Th1/Th2 imbalance and facial nerve inflammation}},
  author = {Xing Tang and Ziqin Ji and Xueling Xiao and Tongtong Zhu and Shoujen Lan and Yeayin Yen and Xin Shao and Shune Tan and Chao Wang and Jicheng Zhang},
  journal = {Frontiers in immunology},
  year = {2026},
  month = sep,
  doi = {10.3389/fimmu.2026.1718030},
  url = {https://europepmc.org/article/PMC/PMC13661323},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The effect of low-temperature-induced immune activation in elderly idiopathic facial palsy: the association between Th1/Th2 imbalance and facial nerve inflammation
AU  - Xing Tang
AU  - Ziqin Ji
AU  - Xueling Xiao
AU  - Tongtong Zhu
AU  - Shoujen Lan
AU  - Yeayin Yen
AU  - Xin Shao
AU  - Shune Tan
AU  - Chao Wang
AU  - Jicheng Zhang
PY  - 2026
DA  - 2026/09/30
JO  - Frontiers in immunology
DO  - 10.3389/fimmu.2026.1718030
UR  - https://europepmc.org/article/PMC/PMC13661323
AB  - The pathogenesis of idiopathic facial palsy in the elderly has not been fully elucidated. Recent studies have shown that exposure to low temperatures may participate in the pathological process through immune-mediated pathways. This article reviews that cold stimulation can disrupt the Th1/Th2 immune balance, manifested as reduced secretion of Th1-type cytokines and upregulation of Th2-type cytokines, thereby inducing peripheral inflammatory responses around the facial nerve, leading to nerve edema, demyelination, and conduction dysfunction. Due to the immune aging characteristics of the elderly population, including the reduction of the initial T cell pool, the imbalance of pro-inflammatory and anti-inflammatory factor ratios, and the decline in regulatory T cell function, they are more sensitive to the immune dysregulation induced by low temperatures and have a significantly increased risk of facial palsy. Clinical and animal experimental evidence supports this mechanism, suggesting that the serum IL-4/IFN-γ ratio may serve as a prognostic marker. Future multi-center studies are needed to verify the effectiveness of targeted immune regulation intervention through the Th2 pathway and explore the application value of low-temperature warning and individualized warming strategies in the prevention of facial palsy in the elderly.
SN  - 1664-3224
ER  -