Su Qiang, Li Lang, Zhao Jinmin, Sun Yuhan, Yang Huafeng
Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Guangxi 530021, China.
Oncotarget. 2017 Sep 18;8(62):104992-104999. doi: 10.18632/oncotarget.20975. eCollection 2017 Dec 1.
Post-percutaneous coronary intervention (PCI) myocardial injury is related to the CD4+ T lymphocyte-mediated inflammatory response. microRNA-21 expression is associated with CD4+ T lymphocyte activation. The pre-PCI use of trimetazidine prevents periprocedural myocardial injury and reduces inflammatory cytokine levels. This study aimed to assess the effects of trimetazidine on periprocedural microRNA-21 expression by CD4+ T lymphocytes in patients with unstable angina pectoris.
A total of 252 patients with unstable angina pectoris were randomized to the trimetazidine (60 mg/d, administered 3 days before PCI, n=128) and control (no trimetazidine, n=124) groups. Serum CK-MB, cTnI, and hs-CRP levels were tested pre-PCI and 16-24 h post-PCI. Peripheral blood CD4+ T lymphocytes were isolated by magnetic activated cell sorting. Quantitative polymerase chain reaction was used to assess microRNA-21 and PDCD4 mRNA expression levels in CD4+ T lymphocytes, and western blot was used to evaluate PDCD4 protein expression. Enzyme-linked immunosorbent assay was used to assess serum TNF-α and IL-10 levels.
Compared with the control group, the trimetazidine group had a lower frequency of patients with post-PCI serum CK-MB and cTnI levels higher than normal values; the trimetazidine group had also significantly lower serum hs-CRP and TNF-α levels, and higher IL-10 levels post-PCI. Finally, the trimetazidine group had significantly lower PDCD4 expression and higher microRNA-21 levels in CD4+ T lymphocytes post-PCI.
Trimetazidine reduces the incidence of periprocedural myocardial injury, possibly by increasing microRNA-21 levels in CD4+ T lymphocytes and inhibiting PDCD4-mediated inflammatory response.
经皮冠状动脉介入治疗（PCI）后心肌损伤与CD4+ T淋巴细胞介导的炎症反应有关。微小RNA-21的表达与CD4+ T淋巴细胞活化相关。PCI术前使用曲美他嗪可预防围手术期心肌损伤并降低炎症细胞因子水平。本研究旨在评估曲美他嗪对不稳定型心绞痛患者围手术期CD4+ T淋巴细胞微小RNA-21表达的影响。
总共252例不稳定型心绞痛患者被随机分为曲美他嗪组（60 mg/d，PCI术前3天给药，n = 128）和对照组（未使用曲美他嗪，n = 124）。在PCI术前及术后16 - 24小时检测血清肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）和高敏C反应蛋白（hs-CRP）水平。通过磁珠分选法分离外周血CD4+ T淋巴细胞。采用定量聚合酶链反应评估CD4+ T淋巴细胞中微小RNA-21和程序性细胞死亡蛋白4（PDCD4）mRNA表达水平，采用蛋白质印迹法评估PDCD4蛋白表达。采用酶联免疫吸附测定法评估血清肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平。
与对照组相比，曲美他嗪组PCI术后血清CK-MB和cTnI水平高于正常值的患者频率较低；曲美他嗪组PCI术后血清hs-CRP和TNF-α水平也显著较低，而IL-10水平较高。最后，曲美他嗪组PCI术后CD4+ T淋巴细胞中PDCD4表达显著较低，微小RNA-21水平较高。
曲美他嗪可能通过提高CD4+ T淋巴细胞中微小RNA-21水平并抑制PDCD4介导的炎症反应来降低围手术期心肌损伤的发生率。
