| Objective Correlation between the pathogenesis of coronary heart disease and molecular immunity has not been reported in detail at home and abroad.This study was designed to explore the expression levels of Th17 cells and related inflammatory factors in peripheral blood of patients with acute coronary syndrome(ACS),to confirm the correlation with disease development from the level of molecular immunity,and to provide new ideas and open up new ways for the molecular mechanism and prevention of coronary heart disease.Methods The 100 patients with coronary atherosclerosis diagnosed in Qingdao Fuwai Cardiovascular Hospital from February 2016 to January 2017 were collected,including acute myocardial infarction AMI(20 cases),unstable angina pectoris UA(20cases),stable Angina pectoris SA(60 cases)and 30 healthy physical examination specimens were used as normal control group(HC group).Fasting venous blood was collected for anticoagulation with heparin,flow cytometry was used to detect Th17 cell ratio of patients in each group,ELISA method was used to detect the expression levels of Th17 cell related factors IL-17,IL-21,IL-23,and IL-6 in each group of serum.Use dry immunofluorescence method to measure CRP level,biochemical indicators such as enzymatic method to detect triglyceride(TG),total cholesterol(TCHOL),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),glucose(GLU),homocysteine(HCY)expression in each group.Results In order to study the correlation between Th17 and ACS,Th17 cells in peripheral blood were detected by flow cytometry.The results showed that the expression level of peripheral blood Th17 cells in ACS patients(UA group and AMI group)was increased(P <0.05).And the elevated level of AMI group was significantly higher than that of UA group(P <0.05),the elevated level of UA group was significantly higher than that of SA group(P <0.05),but there was no significant difference between SA group and HC group(P>0.05);The main effector molecules of Th17,IL-17 and IL-21,were detected by ELISA.The results showed that the expression levels of IL-17 and IL-21 in the AMI group were significantly higher than those in the UA group(P <0.05),and the elevated levels in the UA group were significantly higher than SA group(P <0.05),no significantdifference between SA group and HC group(P>0.05);ELISA method was used to detect the cytokines IL-23 and IL-6.The results showed that compared with the control group,the expression levels of IL-23 and IL-6 in each group increased to varying degrees,especially in the AMI group;The elevated level of AMI group was significantly higher than that of UA group(P <0.05),the elevated level of UA group was significantly higher than that of SA group(P <0.05),and the elevated level of SA group was significantly higher than that of HC group(P<0.05).The other risk factors of coronary atherosclerosis were analyzed.Compared with the control group,the CRP expression level of each group was significantly increased(P<0.05),the CRP expression level of the AMI group was significantly higher than that of UA(P <0.05),and the UA group was significantly higher than SA group(P <0.05),SA group increased level was significantly higher than HC group(P<0.05),the difference was statistically significant.Compared with the control group,the serum TCHOL,TG,LDL-C levels in the SA,UA,and AMI groups were higher than those in the normal control group(P<0.05),while the HDL-C levels were lower than those in the normal control group(P<0.05).There was no significant difference between groups UA and AMI(P>0.05);GLU expression level of AMI group,UA group and SA group was significantly higher than that of control group(P <0.05),but there was no significant difference between AMI group,UA group and SA group;The expression level of Hcy in AMI group was significantly higher than that of UA group(P <0.05).The elevated level of UA group was significantly higher than that of SA group(P <0.05).The elevated level of SA group was significantly higher than that of HC group(P <0.05),Differences between groups are statistically significant.To study the relationship between Th17 cells and its effector IL-17 and other coronary atherosclerosis risk factors,it was found that Th17 cells,IL-17 and TG,TCHOL,HDL-C,LDL-C,GLU,Hcy have no correlation.It shows that CHD is the result of multiple factors.During the development of ACS,Th17 cells and IL-17 are not directly involved in the metabolism of blood glucose,blood lipids and homocysteine;The correlation between IL-17 and IL-21,IL-23,IL-6 was analyzed,and it was found that IL-17 was highly correlated with IL-23(r = 0.9209,p <0.01),and highly correlated with IL-6(r = 0.9870,p <0.01);Studies have shown that abnormal expression of IL-17,IL-21 in Th17 cells is the main molecular mechanism leading to the occurrence of acute coronary syndrome,IL-17,IL-23,IL-21,IL-6 have guiding value for the auxiliary diagnosis of ACS.Conclusion1.This study confirmed that the expression of Th17 cells in ACS patients was significantly increased;especially in the AMI group.This indicates that the occurrence of ACS is related to the activation of Th17 cells.2.The IL-17?IL-21?IL-23?IL-6 levels of Th17 cell-related inflammatory cytokines were significantly increased in ACS patients,and the IL-17 was positively correlated with the changes of serum IL-6?IL-23 concentration,so the opening of inflammatory signaling pathway was the main molecular basis of ACS.3.The increased levels of TC,TCHOL,LDL-C,Glu,and Hcy in the serum of ACS patients indicate that ACS patients have endocrine-immune disorders,but there is no direct correlation with Th17 cells and IL-17.ACS is the result of multiple factors.4.By analyzing the ROC curve of Th17 cells and related cytokines,Th17 cells,IL-17,IL-6,IL-23,IL-21 can be used as ACS auxiliary diagnostic indicators.This study provides a basis for the molecular immune mechanism of coronary heart disease and has important guiding value for the diagnosis and treatment of this disease. |
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