Effect Of Th17 Related Cytokines In Acute Coronary Syndrome Patients

Objective:It has been proved that atherosclerosis is an chronic inflammatory disease. The development of AS leads to plaque rupture and Thrombosis and finally cause ACS.Since Th17 related cytokines plays a key role in inflammatory response,we detect the levels of Th17 related cytokines in the serums of patients with acute myocardial infarction to explore the effect of these cytokines on the development of ACS.Methods:From June to September 2014, participants were 72 patients who had been diagnosed with acute coronary syndrome in Xiamen Heart Center. 72 ACS patients were divided into 3 groups-ST-segment elevation myocardial infarction group(n=32) and non-ST-segment elevation myocardial infarction group(n=28) and unstable angina group(n=12) by related guidelines. 20 patients with normal coronary at the same period were regarded as control group(n=20).Clinical data such as gender,age,smoking history and some related diseases had been recorded attentively.The concentrations of 15 Th17 related cytokines in the serum samples were detected by Bio-Plex liquid suspension array technique.We calculated the Gensini score according to the result of coronary angiography.Results:(1)The levels of IL-17 A,IL-6,s CD40 L,TNF-α,IFN-γ and IL-10 in the STEMI,NSTEMI and UA groups were all significantly increased compared with control group(P<0.01), while there was a higher level of IL-6 in STEMI group than in NSTEMI and UA groups(P=0.017,0.037).But the level of IFN-γ in STEMI group was lower than NSTEMI and UA groups(P=0.007,0.0015).There was no significant difference among the experimental groups in the other cytokines above(P>0.05);(2)The serum level of IL-1βin STEMI group was higher than control group(P=0.015)and UA group(P=0.012)while there was no difference among NSTEMI,UA and controlgroups(P>0.05);(3) The 3 experimental groups’ average increasing degrees of plasma IL-6,IL-17 A and TNF- α were higer than other cytokines(the multiples were 20.54,10.07,7.75);(4)No significant difference was been found among the 4 groups in the levels of IL-4, IL-31, IL-17 F, IL-25, IL-33, IL-22, IL-23, IL-21(p>0.05);(5)The levels of IL-17 A,s CD40 L,TNF- α,IL-6 were positively correlated with Gensini score(r=0.587,0.391,0.464,0.459; P=<0.001,0.001,0.012,0.015)while the levels of IFN-γ,IL-10,IL-1 β showed no significant correlation with Gensini score(P>0.05),in addition the correlations still exist in each experimental group;(6) Multi-factor regression analysis showed that the serum levels of IL-17 A,s CD40 L were positively correlated with Gensini score(β=0.517,0.244;P =<0.001、0.015).Conclusion:(1)The serum levels of IL-17 A,IL-6,s CD40 L,TNF-α,IFN-γ,IL-10 and IL-1β increase in ACS patients while IL-6,IL-17 A,TNF-α have higher increasing degrees than other cytokines,implying that they may be some new biomakers in early diagnosis of acute coronary syndrome.(2)The serum levels of IL-17 A and s CD40 L are positively correlated with the severity of coronary lesions.And a high level of IL-17 A may be a strong predictor of critical condition in patients with ACS as well as s CD40 L.