Mukhopadhyay Saibal, Varma Saurabh, Mohan Kumar H N, Yusaf Jamal, Goyal Mayank, Mehta Vimal, Tyagi Sanjay
Professor, Department of Cardiology, G.B. Pant Hospital, New Delhi, India.
Senior Research Scientist, National Institute of Pathology (ICMR), New Delhi, India.
Indian Heart J. 2016 May-Jun;68(3):342-8. doi: 10.1016/j.ihj.2015.08.009. Epub 2016 Jan 19.
The regulatory T cell (Treg) is essential for prevention of autoimmunity. In a preliminary study, we showed significant deficiency of Tregs (CD4CD25 T cells) in rheumatic heart disease (RHD) patients (an autoimmune disease), but the markers used could not reliably differentiate Treg from nonregulatory conventional T cells (Tcon). The study aim was to reassess the level of circulatory Tregs by using more specific markers.
70 adults of RHD and 35 controls were studied. Patients were subdivided according to the extent of left-sided valvular involvement. 35 patients with significant mitral-valve disease only were enrolled in the univalvular group while 35 patents with significant involvement of both mitral and aortic-valves in the multivalvular group. Circulating Treg cell level was determined by flow-cytometry.
Level of Tregs (CD4+CD25(med-high)CD127(low) Foxp3(high)) in CD4+ T lymphocyte was significantly lower in RHD patients compared to controls (median 0.6% versus 3.2%; p=0.001) with no significant difference in Tcon cells (p=0.94). Within the study group Treg count was significantly lower in patients with multivalvular-disease only (median 0.1% versus 3.2%; p=0.001) with no significant difference in Treg cell count between the univalvular group and control (median 1.9% versus 3.2%, p=0.10).
There is significant deficiency of circulating Tregs in patients of chronic RHD and the deficiency is greater in patients with multivalvular than univalvular involvement.
调节性T细胞（Treg）对于预防自身免疫至关重要。在一项初步研究中，我们发现风湿性心脏病（RHD，一种自身免疫性疾病）患者的Tregs（CD4⁺CD25⁺ T细胞）显著缺乏，但所使用的标志物无法可靠地区分Treg与非调节性常规T细胞（Tcon）。本研究的目的是使用更特异的标志物重新评估循环Tregs的水平。
对70例成年RHD患者和35例对照进行研究。患者根据左侧瓣膜受累程度进行细分。单瓣膜组纳入仅患有严重二尖瓣疾病的35例患者，多瓣膜组纳入二尖瓣和主动脉瓣均严重受累的35例患者。通过流式细胞术测定循环Treg细胞水平。
与对照组相比，RHD患者CD4⁺ T淋巴细胞中Tregs（CD4⁺CD25（中高）CD127（低）Foxp3（高））水平显著降低（中位数0.6%对3.2%；p = 0.001），而Tcon细胞无显著差异（p = 0.94）。在研究组中，仅患有多瓣膜疾病的患者Treg计数显著降低（中位数0.1%对3.2%；p = 0.001），单瓣膜组与对照组之间的Treg细胞计数无显著差异（中位数1.9%对3.2%，p = 0.10）。
慢性RHD患者存在循环Tregs显著缺乏，且多瓣膜受累患者的缺乏程度大于单瓣膜受累患者。
