| Focal inflammation of acute cerebral infarction(ACI)can quickly activate the systemic inflammatory cascade,which induces secondary damage to brain tissue.In recent years,it has been found that peripheral T lymphocytes play a key role in the process of injury and repair after ACI.T helper cell 17(Th17)and regulatory T cell(Treg)cells are two different T cell subsets with opposite immune functions.Th17 cells mainly play pro-inflammatory effects and secrete cell inflammatory factors such as interleukin-17(IL-17)and interleukin-6(IL-6),which can aggravate neuronal damage;while Treg cells can coordinate the overall immune response by regulating the activity of effector T cells and maintain peripheral immune tolerance,exerting neuroprotective effects.Therefore,the peripheral blood Th17/Treg ratio can fully reflect the cellular immune situation in patients of ACI.Meanwhile,IL-6,neutrophil to lymphocyte ratio(NLR),C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR)are commonly used in clinical practice to assess the indicators of systemic inflammatory response.Therefore,the combination of multiple inflammation indicators could help to diagnose ACI and evaluate the severity of inflammation more efficiently.Objective To investigate dynamic variation of peripheral blood Th17,Treg and Th17/Treg in patient with acute cerebral infarction(ACI),and level of inflammatory biomarkers including neutrophil to lymphocyte ratio(NLR),IL-6,CRP and ESR.Methods 32 patients with ACI and 32 healthy controls were enrolled.The levels of peripheral blood Th17 and Treg in patient with ACI were detected by flow cytometry at day 1,day 4 and day 7 after admission,and then compared with healthy controls.At the same time,those relevant inflammatory biomarkers were also examined and analyzed.According to National Institute of Health stroke scale(NIHSS)scores,the patients were divided into mild group,moderate-to-severe group.The differences in the proportion of Th17,Treg and Th17/Treg between this two groups of peripheral blood was also analyzed.Results1.The risk factors of ACI patients such as age,gender,hypertension,diabetes,hyperlipidemia were not significantly different from those in the control group(P>0.05).2.The level of Th17,Th17/Treg and Treg in different NIHSS scores groups were significantly different(P<0.05).3.Compared with control group,the proportion of Th17 and Treg cells were evidently different on patients 1 and 4 days after stroke(P<0.05).Then,those cells gradually recovered at 7 days after stroke,with no statistical significance compared with controls(P>0.05).However,there were consistently significant differences in elevated ratio of Th17/Treg,and high level of IL-6,NLR and CRP from day 1 to day 7 after stroke in comparation with controls(P<0.05).The ESR in patients with ACI had significant differences compared with controls at 4,7 days(P<0.05),except day 1 after admission(P>0.05).4.The proportion of Th17(p=0.298,P=0.007)and Treg(p=-0.242,P=0.029),Th17/Treg(p=0.351,P=0.001),NLR(p=0.377,P=0.001),CRP(p=0.582,P=0.000),ESR(p=0.388,P=0.000)all showed significant correlations with IL-6.Conclusion1.There may be imbalance of Th17/Treg and systemic inflammatory response in patients with ACI.2.The expression of peripheral Th17,Treg and Th17/Treg alters in the development of ACI and is closely related to the severity of the ACI.3.IL-6 not only acts on the regulation of Th17/Treg balance,but also reflects the dynamic changes of systemic inflammation in patients with ACI together with ESR,NLR and CRP. |
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