Regulatory T Cells/T-helper Cell 17 Functional Imbalance In Uraemic Patients On The Micro-inflammatory State And Cardiovascular Function

Objective:To identify balance changes of Treg/Th17 cells in uremic patients by studying the RORyt gene and Foxp3 gene expression,and to investigate the effect of the banlance changes in micro-inflammation of uremic patients and the impact to development of cardiovascular disease in patients with maintenance hemodialysis.Methods:30 uremia patients were selected in the study.Of the 30 patients,10 patients without dialysis were internalized into CKD group,while the other 20 patients weith dialysis were internalized into MHD group.MHD group were further divided into two groups according to cardiac function,ie LVEF>50% for MHD1 group,LVEF<50% for the MHD2 group.Additionally, select 10 patients with normal heart and renal function as control group(A group). Phlebotomize 2 ml from fasting patients of the experimental group in the morning with EDTA anticoagulant tube,then extracted lymphocytes using lymphocyte separation medium and reserved top serum collected IL-6,IL-10,IL-17were representative fator of micro-inflammation inflammatory cytokines.Check the correlation between the imbalance of Treg and Th17 inflammation and micro-inflammation by analyzing the correlations among IL-6,IL-10 Foxp3 and RORγt.At last,RT-PCR was made by further extracting,RNA from lymphocytes.Then semi-quantitative analysis of transcription fator Foxp3 Treg and Th17 transcription factor RORyt were made to further analyze the balance changes of Treg and Th17.Results:Analysis of variance with,completely randomized design was taken to compare the normal control group and the uremic group patients. The expression of Foxp3 and RORyt were significantly imbalanced(P<0.05), RORyt expression significantly increased in the uremic group and Foxp3 significantly decreased in the MHD2 group which was more obvious..However,there was no difference between CKD groups and MHD1 groups(P>0.05).At last correlation analysis was made and found that RORyt was positively correlated with IL-6,IL-17,hsCRP and was negatively correlated with IL-10;besides Foxp3 was positively correlated with IL-10 and was negative correlated with IL-6,IL-17and hsCRP.Conclusions:There is imbalance between Treg and Th17 cells in uremic patients,which is not only correlated to the micro-inflammatory state in uraemia patients,but also to the development of cardiovascular disease in maintenance hemodialysis patients.