阿托伐他汀对颈动脉粥样硬化患者Th17细胞Treg细胞及其效应分子的调节作用

The regulation of Atorvastatin on Th17/Treg cells in patients with carotid atherosclerosis

目的探讨颈动脉粥样硬化斑块患者辅助性T细胞(Th17)/调节性T细胞(Treg)及相关细胞因子的表达情况,及阿托伐他汀降脂对其改善作用。方法选取2016年1月至2017年1月,海南省人民医院收治的颈动脉粥样硬化斑块患者80例,随机分为试验组与对照组,每组40例,并同期选择80例健康志愿者为正常组。试验组患者予口服阿托伐他汀钙40 mg/d,1次/d,对照组给予同等剂量的安慰剂。对三组患者进行颈动脉斑块超声检测,Th17/Treg细胞百分比检测,血清炎症因子检测,RORγt mRNA检测。结果治疗前后,试验组和对照组颈动脉斑块厚度差异均无统计学意义(P>0.05)。治疗3个月后,两组患者空腹血糖(FPG)、甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均下降,高密度脂蛋白胆固醇(HDL-C)水平升高,差异有统计学意义(P<0.05)。治疗3个月后,两组Th17占CD4^+细胞百分比、白细胞介素-17(IL-17)、ROR-γt mRNA和IL-17A mRNA较治疗前降低(P<0.05),而Treg细胞百分比、Treg/Th17比值升高(P<0.05),且试验组较对照组改善更为明显(P<0.05)。治疗3个月后,试验组Th17细胞百分比、Treg细胞百分比、Treg/Th17比值、血清IL-17、ROR-γt mRNA和IL-17A mRNA与正常组间差异有统计学意义(P<0.05)。结论颈动脉粥样硬化患者Th17/Treg严重失衡,包括相应的mRNA和相关的白细胞介素,阿托伐他汀可产生较好的回调作用。

Objective To understand the regulation of atorvastatin on helper T cells(Th17)/regulatory T cells(Treg) and related cytokines in patients with carotid atherosclerosis(AS). Methods 80 patients with AS and 80 healthy volunteers in People′s Hospital of Hainan from January 2016 to January 2017 were enrolled in the study. AS patients were randomly and evenly divided into experimental group and control group. Patients in experimental group were given atorvastatin 40 mg once daily, while patients in control group were given the same dose of placebo. Results There was no significant difference in carotid plaque thickness between the experimental group and the control group before and after treatment(P>0.05). After 3 months of treatment, the serum levels of FPG, TG, TC and LDL-C decreased(P<0.05), while the level of HDL-C increased(P<0.05), especially among patients in experimental group.3 months after the treatment, the percentage of Th17 cells, ROR-γt mRNA and IL-17 A mRNA all decreased(P<0.05), while the percentage of Treg cells and Treg/Th17 ratio increased(P<0.05). The percentage of Th17 cells and Treg cells, the ratio of Treg/Th17, serum level of IL-17, expression levels of ROR-γt mRNA and IL-17 A mRNA among patients in experimental group were statistically different from healthy volunteers after 3 months treatment(P<0.05). Conclusions There are serious imbalances in Th17/Treg cells as well as the corresponding mRNA and related interleukin,atorvastatin can improve the balances of above indicators.