Research On The Clinical Signincance And Correlation Of The Alteration Of T-helper17Cells And Th17/Th1Cells In Patients With Acute Coronary Syndrome

Objective Background:To investigate the function of T-helper17cells and Th17/Th1cells in patients with acute coronary syndrome (ACS), examined the expression of Th17, Th17/Th1cells in peripheral blood of ACS patients and a control group of healthy people, and tested the corresponding individual plasma interleukin (IL)-17, IL-22, C-reactive protein (CRP), the blood lipid biochemical indicators and the myocardial injury indicators. Discuss the relationship between various cell populations, related cytokine expression levels and the development of ACS. Clarify the possible association between Th17cells with ACS pathogenesis, to guide ACS diagnosis and treatment.Materials and Methods:24AMI patients,17UA patients,19SA patients and15healthy controls were included in this study. The frequencies of Th17and Th17/Th1cell in AMI, UA, SA patients and healthy controls were examined by flow cytometry. Plasma IL-22and IL-17concentration were measured by enzyme-linked immunosorbent assay (ELISA). Patients enrolled in conventional were recorded with gender, age-related diseases, history of smoking and drinking, and fasting blood samples were collected to test the biochemical indicators and the inflammatory activity indicators, including using immunofluorescence assay to test CRP concentration, enzymatic determination to test total cholesterol (TCH), triglycerides concentration (TG) and low-density lipoprotein concentration (LDLC), and chemical immune chemiluminescence determination to test serum troponin (TnI).Results:1) AMI group and UA group peripheral Th17cell ratio (2.98±1.01)%,(2.63±0.61)%and Th17/Th1cell ratio (0.71±0.35)%,(0.66±0.31)%, significantly higher than the SA group Th17cell ratio (1.63±0.48)%, Thl7/Thl cell ratio (0.28±0.57)%and HC group Th17cell ratio (1.36±0.32)%, Th17/Thl cell ratio (0.26±0.61)%(P <0.05); in patients with ACS of Th17cells Th17/Thl cells showed a significant positive correlation (r=0.567, P<0.01).2) The AMI group plasma IL-17and IL-22concentrations (IL-17:25.08±7.91pg/ml; IL-22:34.18±7.04pg/ml) were significantly higher than those in the SA group (IL-17:17.89±6.08pg/ml; IL-22:27.05±3.68pg/ml) and HC group (IL-17:15.44±2.86pg/ml; IL-22:25.10±2.74pg/ml)(P<0.05); UA plasma IL-17concentration (22.64±7.99pg/ml) was significantly higher than the HC group, AMI group, the SA group difference was not statistically significant (P>0.05); UA plasma IL-22concentration (28.98±4.35pg/ml) significantly below the AMI group was significantly higher than the HC group, and the the SA group difference was not statistically significant (P>0.05); SA group and the HC group, the difference was not statistically significant (P>0.05). ACS plasma IL-22concentration and IL-17concentration showed a significant positive correlation (r=0.422, P<0.01).3) ACS patients Th17cells of IL-17concentration was significantly with positive related (r=0.722, P<0.01) and IL-22concentration was significantly with being related (r=0.400, P<0.01); patients with the SA group Th17cells and of IL-17, IL-22concentration correlation (P=0.465, P=0.621); the HC group IL-17, IL-22concentrations no correlation (P=0.723, P=0.744).4) ACS patients the Th17of cells, Th17/Thl cells with CRP levels showed a significant positive correlation (r=0.513, P<0.01, r=0.575, P<0.01).5) ACS patients Th17cells, Thl7/Thl cells with Tnl concentration showed a significant positive correlation (r=0.432, P<0.01, r=0.509, P<0.01).6) ACS patients Thl7cells Th17/Thl cells with the TCH, TG, LDLC concentrations showed no significant correlation (P=0.308, P=0.771, P=0.204; P=0.522, P=0.393, P=0.387).Conclusion:1) ACS patients peripheral blood of Th17cells and Th17/Thl of cell ratio were increased, also the concentration of plasma IL-17, IL-22, and there was a positive correlation between the proportion of Th17cells and plasma IL-17and IL-22concentration. By secretion of IL-17and IL-22, Th17cells involved in the instability of atherosclerotic plaque and pathogenesis of ACS.2) Th17cells and Thl7/Thl cells proportion were closely related to the incidence of ACS, they could provide the basis for the prediction of arterial plaque instability or rupture, and they also could be regarded as the auxiliary detection and diagnosis indicators of acute cardiovascular events. Furthermore, they were beneficial in patients with CHD risk stratification, and provided the clinical basis to positive and timely intervention.