Intensive statin treatment ameliorate the Th17/Treg functional imbalance in patients with non-ST elevation acute coronary syndrome underwent percutaneous coronary intervention
Intensive statin treatment ameliorate the Th17/Treg functional imbalance in patients with non-ST elevation acute coronary syndrome underwent percutaneous coronary intervention
复制标题
他汀类药物强化治疗改善经皮冠状动脉介入治疗的非ST段抬高型急性冠脉综合征患者Th17/Treg功能失衡
DOI：
10.1002/clc.23326
复制
发表时间：
2019-12-24
影响因子：
2.7
通讯作者：
Yuan, Haitao
中科院分区：
文献类型：
--
作者：
Ma, Xiaojing;Liu, Shilei;Yuan, Haitao
研究背景炎症在急性冠状动脉综合征（ACS）的发病机制中起重要作用。他汀类药物通过抗炎作用对斑块的稳定发挥积极作用，但具体机制尚不清楚。研究提示Th 17/Treg功能失衡在斑块失稳和ACS发病中起重要作用。我们假设强化他汀类药物治疗可以改善ACS患者的Th 17/Treg失衡。方法将66例非ST段抬高急性冠脉综合征（NSTE-ACS）患者随机分为常规组和强化组。在入院时和阿托伐他汀治疗后采集外周血样本。采用流式细胞术和ELISA法分别检测外周血中Th 17细胞和Treg细胞的比例，以及Th 17细胞相关细胞因子（IL-17、IL-6和IL-23）和Treg细胞相关细胞因子（IL-10和TGF-β 1）的水平。结果治疗后1周，两组患者外周血Th 17细胞比例均较治疗前下降，Treg细胞比例较治疗前明显升高。强化组外周血Th 17细胞减少、Treg细胞增加的比例明显高于常规组。两组患者外周血中IL-17、IL-6和IL-23（与Th 17细胞相关的细胞因子）的蓄积均减少，而IL-10和TGF-β 1的蓄积均增加。强化组的变化更为显著。结论他汀类药物强化治疗可改善ACS患者Th 17/Treg功能失衡。
Background Inflammation plays important roles in the pathogenesis of acute coronary syndrome (ACS). Statins exert positive effects on the plaque stabilization through anti-inflammation, however, the detailed mechanism is still under investigation. Hypothesis Studies suggest that the Th17/Treg functional imbalance takes key part in the plaque destabilization and the onset of ACS. We hypothesized that intensive statin therapy could ameliorate the Th17/Treg imbalance in patients with ACS. Methods Sixty-six patients with non-ST elevation acute coronary syndrome (NSTE-ACS) were randomized to conventional group and intensive group. Peripheral blood samples were collected on admission and after atorvastatin treatment. The frequencies of circulating Th17 cells and Treg cells, the levels of cytokines associated with Th17 cells (IL-17, IL-6 and IL-23) and associated with Treg cells (IL-10 and TGF-beta 1) were measured through flow cytometry and ELISA assay respectively. Results One week after therapy, the frequencies of circulating Th17 cells of both the groups decreased and the frequencies of circulating Treg cells increased significantly, compared with the basal levels. Furthermore, the decreased frequencies of circulating Th17 cells and the increased frequencies of circulating Treg cells in the intensive group were significantly higher than those in the conventional group. In consistence, the decreased accumulation of IL-17, IL-6 and IL-23 (cytokines relevant to Th17 cells) and the increased accumulation of IL-10 and TGF-beta 1 in peripheral blood were displayed in both groups. The changes are more significant in the intensive group. Conclusion Intensive statins therapy could ameliorate the Th17 and Treg functional imbalance in patients with ACS.