In NMOSD patients, SATB1 mRNA, RORγt mRNA, and Th17 cells were increased during the acute phase and elevated in remission compared to healthy controls. Conversely, FOXP3 mRNA and Treg cells were downregulated, more significantly in acute phase.A negative correlation was found between SATB1 and FOXP3 mRNA acutely (r = -0.92, P < 0.001), but not in remission (r = -0.44, P = 0.05).In both disease phases, SATB1 expression was positively correlated with RORγt mRNA (r=0.91, P<0.001; r=0.59, P<0.05) and Th17 cells (r=0.92, r=0.88, both P<0.0001), but negatively correlated with Treg cells (all r=-0.71; P<0.05).SATB1 mRNA levels positively correlated with clinical measures (EDSS: r=0.51/0.40; ARR: r=0.68/0.59; all P<0.05) but not with T2FLAIR lesions (r=0.14/0.04, P>0.05) in both acute and remission phases.