急性心肌梗死患者外周血CD4^+CD25^+Foxp3^+调节性T细胞水平与颈动脉内膜中层厚度的相关性

Correlation between CD4^+CD25^+Foxp3^+ Regulatory T Cells in Peripheral Blood of Patients with Acute Myocardial Infarction and Carotid Intima-media Thickness

目的通过观察急性心肌梗死患者外周血CD4+CD25+Foxp3+调节性T细胞(Treg)水平与颈动脉内膜中层厚度(I MT)及炎性介质的相关性,探讨其在此类疾病发病机制中的作用。方法采用流式细胞分析法和酶联免疫吸附法(ELISA),检测50例急性心肌梗死患者(AMI组)和50例健康体检者(对照组)外周血CD4+CD25+Foxp3+Treg水平、超敏C反应蛋白(hs-CRP)、白介素-4(IL-4)、IL-6、IL-10、转化生长因子β(TGF-β)、肿瘤坏死因子-α(TNF-α)等指标。利用高频超声检测AMI患者和对照组颈动脉I MT。结果 AMI患者外周血CD4+CD25+Foxp3+Treg占CD4+CD25+T细胞的百分率显著低于对照组(P<0.01)。AMI患者的I MT、血浆TNF-α、IL-6、hs-CRP水平显著高于对照组(均P<0.05),其CD4+CD25+Foxp3+Treg百分率与血浆IL-10水平呈显著正相关(r=0.682,P<0.05);CD4+CD25+Foxp3+Treg百分率与颈动脉I MT(r=-0.562,P<0.05)、hs-CRP(r=-0.443,P<0.05)、IL-6(r=-0.307,P<0.05)和TNF-α(r=-0.281,P<0.05)水平呈显著负相关。结论调节性T细胞失调可能参与动脉粥样硬化的发生发展,免疫失衡、血管重构及炎性反应可能同时参与了急性冠脉综合征的发病过程。

Objective To investigate the correlation between CD4^＋CD25^＋Foxp3^＋ regulatory T cells（Treg）in peripheral blood of patients with acute myocardial infarction（AMI）with carotid intima-media thickness（IMT）and inflammatory cytokines,and their role in the pathogenesis.Methods By using flow cytometry and enzyme-linked immunosorbent assay（ELISA）,CD4^＋CD25^＋Foxp3^＋ Treg,hypersensitive C reaction protein（hs-CRP）,interleukin（IL）-4,IL-6,IL-10,transforming growth factor-beta（TGF-β）,tumor necrosis factor-alpha（TNF-α）in peripheral blood of 50 cases of AMI（AMI group）and 50 healthy controls（control group）were measured.High-frequency ultrasound was adopted to observe carotid IMT in AMI group and control group.Results In AMI group,the ratio of CD4^＋CD25^＋Foxp3^＋ Treg/CD4＋CD25＋Treg was significantly lower than in control group（P〈0.01）.The carotid IMT,and plasma levels of TNF-α,IL-6,hs-CRP in AMI group were significantly increased as compared with those in control group（P〈0.05）,and the percentage of CD4^＋CD25^＋Foxp3^＋ Treg was markedly positively correlated with plasma IL-10 levels（r=0.682,P〈0.05）.The percentage of CD4^＋CD25^＋Foxp3^＋ Treg was significantly negatively related with carotid IMT（r=-0.562,P〈0.05）,hs-CRP（r=-0.443,P〈0.05）,IL-6（r=-0.307,P〈0.05）and TNF-α（r=-0.281,P〈0.05）.Conclusion The imbalance of Treg may be involved in the development and progress of atherosclerosis.Immune imbalance,vascular remodeling and inflammatory response probably take part in the pathogenesis of acute coronary syndrome.