The Imbalance Between Thl7 And Regulatory T Cells In Patients With Chronic Heart Failure

Objective: To find out the significance of the imbalance between Thl7 and CD4+ CD25+ CD127- regulatory T cells (Treg) and the change of NK cells in patients with chronic heart failure (CHF).Methods: CHF group: 53 cases selected CHF patients, NYHA cardic function gradeⅠ～Ⅱpatients (CHF1 group) 24 patients, 13 males and 11 females, age (65.50±10.88) years. NYHA cardic function gradeⅢ～Ⅳpatients (CHF2 group) 29 patients, 15 males and 14 females, age (64.14±8.33) years. Control group: Another choice of age and sex matched healthy volunteers in our hospital as a control group of 20 cases, 11 males and 9 females, age (62.70±6.54) years. Six o'clock the next morning after admission fasting peripheral venous blood collected 10 ml, heparin anticoagulation, which 2ml were used the rapid quantitative detection of BNP (Biosite's use of BNP-TRIAGE) and Treg cells, NK cells, T cell subsets detection (by flow cytometry using Beike Man company EPICS XL MCL-4C). The remaining 8 ml lymphocyte separation medium obtained using human peripheral blood mononuclear cells (PBMC), used for the detection of Th17 cells. PHILIPS IE 5500 model also used color Doppler ultrasound equipment, in the parasternal long axis view of left ventricular chordae measured the level of left ventricular end diastolic diameter (LVEDd), left ventricular long axis view obtained the level of chordae measured left ventricular M-mode ultrasound radiation blood fraction (LVEF).Results: The proportion of Thl7 cells was significantly higher in patients with CHF1 group and CHF2 group than that in healthy controls (1.89±1.24 vs 0.51±0.35 , 3.35±1.78 vs 0.51±0.35 ; P<0.05; P<0.01) , The proportion of Thl7 cells was significantly higher in patients with CHF2 group than that in patients with CHF1 group (3.35±1.78 vs 1.89±1.24 , P<0.01) ; The proportion of CD4+ CD25+ CD127- Treg was significantly lower in patients with CHF1 group and CHF2 group than that in healthy controls (5.69±0.74 vs 7.89±1.66 , 3.31±0.98 vs 7.89±1.66 ; P<0.01; P<0.01) , The proportion of CD4+ CD25+ CD127- Treg was significantly lower in patients with CHF2 group than that in patients with CHF1 group (3.31±0.98 vs 5.69±0.74 , P<0.01) ; that the ration of Th17/Treg was significantly higher in patients with CHF1 group and CHF2 group than that in healthy controls (0.35±0.17 vs 0.11±0.09 , 1.06±0.49 vs 0.11±0.09 ; P<0.05; P<0.01). and it was confirmed that the ration of Th17/Treg was significantly higher in patients with CHF2 group than that in patients with CHF1 group(1.06±0.49 vs,0.35±0.17 , P<0.01)。The proportion of NK was significantly lower in patients with CHF1 group and CHF2 group than that in healthy controls (16.27±1.93 vs 18.43±1.87 , 10.78±1.84 vs 18.43±1.87 ; P<0.01; P<0.01), The proportion of NK was significantly lower in patients with CHF2 group than that in patients with CHF1 group (10.78±1.84 vs 16.27±1.93 , P<0.01);Conclusion: CHF patients with an increase in the percentage of Th17 cells, Treg cell ration decreased, leading to the imbalance between Th17/Treg cells, and with a certain relationship between the serverity of heart failure. Accompanied by reduction in peripheral blood NK cells ratio and the severity of heart failure have a certain relationship. Th17/Treg cells and NK cells ratio imbalance may be involved in the incidence of CHF development.