Statins Has An Immunomodulatory Effect On The Th17/Treg Functional Imbalance In Patients With ACS

BackgroundAcute coronary syndrome[ACS,including unstable angina pectoris and acute myocardial infarction]occurs as a consequence of coronary plaque erosion or rupture.The present study suggests that inflammation and immunity play an important role in the pathogenesis of ACS.Recently,CANTOS study showed that pure anti-inflammatory intervention can significantly reduce cardiovascular events,which provided definitive evidence-based medical evidence for the atherosclerotic inflammation hypothesis.The Th17/Treg functional imbalance may plays an potential role in plaque destabilization and the onset of ACS.A number of recent studies have shown that statins intervention can ameliorate the Th17/Treg functional imbalance of many immune system diseases,such as Kawasaki disease,asthma,hypertension,etc.In addition,one studies have shown that statins intervention improve the quantity and suppressive function of Treg cells in patients with ACS.But so far,there is no clinical evidence that statins intervention is beneficial to ameliorate the Th17/Treg functional imbalance in patients with ACS.Method72 patients with ACS were randomly divided into conventional group(It was future divided into conventional UA group and conventional AMI group)and intensive group(It was further divided into intensive UA group and intensive AMI group).20 patients with stable angina pectoris(SA)were set as the control group.The patients in the control group and the conventional group were treated with 20mg atorvastatin,while the patients in the intensive group were treated with 40mg atorvastatin.the general clinical data and laboratory biochemical indexes of the patients were collected after admission.Peripheral blood samples from all the patients were collection on the day before the atorvastatin intervention and after one week days atorvastatin intervention,which were used to detect the frequencies of circulating Th17 cells and the levels of main cytokines associated with Th 17 cells(IL-17,IL-6 and IL-23),the frequencies of circulating Treg cells and the levels of main cytokines associated with Treg cells(IL-10 and TGF-?1).Results(1)Prior to stains intervention,the frequencies of circulating Th17 cells and the levels of main cytokines associated with Th17 cells(IL-17,IL-6 and IL-23)in patients with ACS were significantly higher than those in the control group(P<0.01),while the frequencies of circulating Treg cells and the levels of main cytokines associated with Treg cells(IL-10 and TGF-?1)in patients with ACS were significantly lower than those in the control group(P<0.01).(2)One week stains intervention significantly decreased the frequencies of circulating Th17 cells and the levels of main cytokines associated with Th17 cells(IL-17,IL-6 and IL-23)in patients with ACS(P<0.01)while increasing the circulating frequencies of Treg cells and the levels of main cytokines associated with Treg cells(IL-10 and TGF-?1)in patients with ACS(P<0.01).(3)The decreased frequencies of the circulating Th 17 cells,the reduced levels of main cytokines associated with Th17 cells(IL-17,IL-6 and IL-23),the increased frequencies the circulating Treg cells frequencies and the elevated levels of main cytokines associated with Treg cells(IL-10 and TGF-?1)in the intensive UA group were significantly higher than those in the conventional UA group(P<0.01);Meanwhile the decreased frequencies of the circulating Th17 cells,the reduced levels of main cytokines associated with Th17 cells(IL-17,IL-6 and IL-23),the increased frequencies the circulating Treg cells frequencies and the elevated levels of main cytokines associated with Treg cells(IL-10 and TGF-?1)were significantly higher as compared with those in the conventional UA group and the conventional AMI group(P<0.01),which were higeher than those in the intensive group(P<0.05).ConclusionOur study confirmed that the Th17/Treg functional imbalance may play an important role in plaque destabilization and the onset of ACS.Statins intervention can ameliorate the Th17/Treg functional imbalance in patients with ACS.Compared to conventional doses statins intervention,intensive doses statins intervention is more beneficial to ameliorate the Th17/Treg functional imbalance in patients with ACS,especially in patients with AMI.Therefore,statins intervention,especially the intensive dose statins intervention,is expected to provide a new research target for the treatment of ACS with immunoregulation.