| Background: Through the analysis and comparison of Th17 cells in heart tissue and serum of rheumatic heart disease patients and the establishment of Lewis rat model of rheumatic heart disease, to clarify the changes in the expression of Th17 cell related cytokines, such as IL-17, IL-21, IL-23, IL-6in the development of rheumatic heart disease, and investigate the significance and mechanism of Th17 cells in the pathological and physiological process of valve injury in rheumatic heart disease.Method : Patients with mitral valve of rheumatic heart disease were selected as research group (n=20), patients with posterior mitral valve prolapse of non-rheumatic heart disease were selected as research group (n=12). We make the anterior mitral valves from surgical operation as specimens, collecting the clinical data at the same time, and detect the expression of IL-17, IL-21, IL-6 and IL-23 in mitral valve tissues of human RHD patients by immunohistochemical method. Moreover, taking 30 healthy Lewis rats to establish models of experimental rheumatic heart disease, which were induced by A Group Hemolytic Streptococcus and complete Freund's emulsion, and dividing the rats into three groups randomly, ten rats of each group. After the intervention of 7w and 24w, detecting the levels of Th17 key cytokine IL-17 and IL-6 in serum and heart tissue by Luminex liquid protein chip means and immunohistochemistry method respectively.Results: (1) HE staining was used to observe the pathological changes of valve tissue: The mitral valve tissues of patients with rheumatic heart disease showed local cerebral chronic inflammatory cell infiltration, while the control group had no obvious inflammatory cell; In the Lewis rat models, the group of 7w showed that myocardial interstitial and valve were loose, edema,inflammatory exudatio and local cerebral lymphocyte infiltration. While in the group of 24w , lymphocytes and plasma cells were found to be the main infiltration cells, anischkow cell aggregation was seen in the myocardium, and the valves were thickened, partial fibrosis and calcification. (2)Immunohistochemical staining results:IL-17, IL-21, IL-6 and IL-23 were detected in mitral valves of two groups patients, the results showed that the expression of IL-17, IL-21, IL-6 and IL-23 were significantly increased compared with the control group (P<0.05), the difference was statistically significant. And there was no difference between the group of 7w and group 24w.(3) Results of serum Liquichip Luminex in Lewis rat model: compared with the control group, the levels of IL-6 and IL-17 in group 7w and group 24w were significantly high (P<0.017), the difference was statistically significant, and there was statistically significant between the 7w group and the 24w group.Conclusions: In this study, Th17 cell axis related cytokines human chronic rheumatic heart disease and experimental RHD animal model were detected,the results showed that IL-17, IL-21, IL-6 and Th17 were highly expressed in the serum and heart tissue of RHD model animals, as well as in the heart valve of RHD patients with chronic injury. Therefore, by adjusting pro-inflammatory or anti-inflammatory cytokines and specific transcription factors oriented Th17 cell may be expected to be a new method for early prevention, diagnosis or treatment of RHD patients. |
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