急性冠脉综合征患者共刺激分子PD-1、CD28的表达变化分析

Disregulated expression of co-stimulatory molecules PD-1 and CD28 on peripheral T lymphocytes in patients with acute coronary syndrome

目的探讨外周血T淋巴细胞共刺激分子,程序性细胞死亡因子-1(PD-1)和CD28在急性冠脉综合征(ACS)疾病进展中的意义。方法选取急性心肌梗死(AMI组)患者25例、不稳定型心绞痛(UAP组)患者25例、稳定型心绞痛(SAP组)患者10例作为研究对象,临床上冠脉造影正常的患者11例作为对照组,采用流式细胞仪测定各组患者CD4+T淋巴细胞上PD-1和CD28的表达情况。结果与SAP组和对照组相比,AMI组及UAP组CD4+、PD-1+双阳性细胞比例增高(P<0.05),而CD4+、CD28+双阳性细胞比例无明显变化(P>0.05)。结论急性冠脉综合征患者中,作为负调控因子的PD-1表达增强,可能在冠状动脉粥样硬化斑块失稳定和疾病进展中起到作用。

Objective To investigate the pathogenic roles of co-stimulatory molecules, programmed death-1 （PD-1） and CD28 on peripheral T lymphocytes in disrupture of atherosclerotic plaque during the progression of acute coronary syndrome （ACS）. Methods Twenty-five patients with acute myocardial infarction （AMI）, 25 with unstable angina pectoris （UAP）, 10 with stable angina pectoris （SAP） and 11 subjects with normal coronary angiography （control） were enrolled in this study. The ex- pression of co-stimulatory molecules PD-1 and CD28 expressed on CD4＋T lymphocytes were examined by flow cytometry. Results Compared with SAP group and normal controls, the proportion of CD4＋PD-1＋cells was significantly increased in AMI and UAP patients （P 〈 0.05）, while CD28 expression level was comparable. Conclusion PD-1 expression on CD4＋ T cells significantly increases in ACS patients, suggesting that immune perturbation of T lymphocytes co-stimulatory pathway might affect the development of atherosclerosis.