| Backgroud (1) Coronary atherosclerotic heart disease is the most common type of organic pathology caused by atherosclerosis, and it is a common disease harmful to health of people. In recent years, incidence and mortality of coronary heart disease have an markedly increasing tendency. So doing studies on coronary heart disease are very important and essential. (2) Atherosclerosis is a multifactorial disorder in which immune mechanisms appear to play a dominant role. In the development and progression of atherosclerosis, there are inflammatory reactions, of which activate mechanism isn't clear. In the past, studies almost focus on factors promoting inflammatory reaction, and studies about factors inhibiting inflammation are seldom. Recent studies suggest that CD4+CD25+regulatory T cells (Tregs) with immunosuppressive function exist in human body and are critical in maintaining immune tolerance and preventing autoimmune disease and inflammatory disease. Treg cells may act through cell-cell contact dependent mechanisms, through production of immunosuppressive mediators (IL-10,TGF-β) or both. (3) The pathological basis of acute coronary syndrome is unstable atheromatous plaque accompanying with succeeding pathological change to diffenerent extent. The problem that how to stabilize plaque still need to be solved.Objective To observe the change of the number of CD4+CD25+ regulatory T cells (Tregs), CD4+Tcells and CD8+Tcells, the change of serum concentrations of interleukin-10 (IL-10) and transforming growth factor-β(TGF-β), and analyze the change of immune function in patients with acute coronary syndrome (ACS). To investigate the correlation between CD4+CD25+ regulatory T cells, immunosuppressive cytokines and the stability of plaques, the role of Treg and immunosuppressive cytokines on the development and progression of acute coronary syndrome.Method Three group of subjects were enrolled: group1, patients with acute coronary syndrome (ACS) (n=30); group2, patients with stable angina (SA) (n=18); group3, subjects with normal coronary artery on angiography (NCA) (n=18). Blood samples of all subjects were collected on an empty stomach in the morning. Peripheral numbers of T lymphocytes were evaluated by fluorescence-activated cell sorting (FACS) employing labelled antibodies to CD4,CD8 and CD25. The serum concentrations of TGF-βand IL-10 were measured using an ELISA technique. The levels of blood glucose and blood lipid were detected routinely.Result (1) Patients with ACS exhibited significantly reduced numbers of peripheral CD4+CD25+ regulatory T cells (Tregs)[(4.02±1.94)%]as compared with patients with SA [(7.19±1.98)%]and normal coronary artery subjects[(8.40±1.99)%](P<0.05) . However, there is no signifinant diffenernce about this item between SA group and NCA group (P>0.05). The ratio of CD4+Tcells to CD8+Tcells in peripheral blood of ACS group(2.04±0.55) was significantly higher than that of SA group(1.52±0.32)and NCA group(1.17±0.27); in peripheral blood of SA group, it was significantly higher than that of NCA group (P<0.05). (2) The levels of TGF-βand IL-10 in peripheral blood of ACS group[(5.95±2.13)ng/ml,(11.35±2.04)pg/ml] were markedly lower than those in SA group[(9.32±2.13)ng/ml,(13.94±2.00)pg/ml]and NCA group[(10.82±3.08)ng/ml,(15.16±2.08)pg/ml](P<0.05). It showed no significant difference between SA group and NCA group (P>0.05).Conclusion (1) The imbalance between autoreactive T cells and regulatory T cells occurs in the patients with ACS .The immune system dysregulation may be a factor causing change of the stability of plaques and participates in the development and progression of acute coronary syndrome.. (2) As anti-inflammatory cells and cytokines, CD4+CD25+regulatory T cells, IL-10 and TGF-βmay be helpful to stabilize plaque and play a protective role in the development and progression of atherosclerosis. Besides, in the development of acute coronary syndrome , the serum level of IL-10 and TGF-βdegrade markedly, and it may change dynamically.
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