心脏再同步治疗对晚期心力衰竭患者循环中产生白细胞介素-17的细胞的影响。

Impact of cardiac resynchronization therapy on circulating IL-17 producing cells in patients with advanced heart failure.

作者信息

Martins Sílvia, Carvalheiro Tiago, Laranjeira Paula, Martinho António, Elvas Luís, Gonçalves Lino, Tomaz Cândida, António Natália, Paiva Artur

机构信息

CICS-UBI - Centro de Investigação em Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal.

Coimbra Institute for Clinical and Biomedical Research, Faculdade de Medicina, Coimbra, Portugal.

出版信息

J Interv Card Electrophysiol. 2019 Apr;54(3):257-265. doi: 10.1007/s10840-018-0491-3. Epub 2018 Nov 27.

DOI:10.1007/s10840-018-0491-3

PMID:30483979

Abstract

PURPOSE

IL-17-producing T cells have been implicated in the inflammatory milieu of chronic heart failure (CHF), which implies a dismal prognosis in affected patients. The aim of this study was to evaluate the impact of cardiac resynchronization therapy (CRT) on the frequency and functional activity of Th17 and Tc17 cells, as well as, on IL-17 mRNA expression in patients with CHF.

METHODS

Twenty-eight patients with CHF, analyzed before CRT (T0) and 6 months later (T6), and 15 healthy controls (HC) were enrolled in this study. Circulating Th17 and Tc17 cells were evaluated by flow cytometry. The quantification of IL-17A mRNA expression was performed by real-time PCR.

RESULTS

Circulating Tc17 cells tended to be higher in CHF patients submitted to CRT than in HC (0.92% (0.24-3.32) versus 0.60% (0.09-3.68), although not reaching statistical significance. The frequency of Tc17 cells in CHF patients significantly decreases after CRT reaching levels similar to those of HC (0.92% (0.24-3.32) at T0 versus 0.56% (0.21-4.20) at T6, P < 0.05), mainly due to responders to CRT. Additionally, the expression of IL-17 mRNA was detected in a few number of responder patients at T0 (27%) and only detected in one responder at T6 (7%). Conversely, in non-responders, the proportion of patients exhibiting IL-17 mRNA expression increases from baseline (17%) to T6 (42%). No significant differences were observed in Th17 cells between HC, CHF patients in T0 and patients in T6.

CONCLUSION

The inflammatory response mediated by circulating IL-17 producing cells seems to be suppressed by CRT, particularly in responders.

摘要

目的

产生白细胞介素-17（IL-17）的T细胞与慢性心力衰竭（CHF）的炎症环境有关，这意味着受影响患者的预后不佳。本研究的目的是评估心脏再同步治疗（CRT）对CHF患者中辅助性T细胞17（Th17）和细胞毒性T细胞17（Tc17）的频率和功能活性以及IL-17 mRNA表达的影响。

方法

本研究纳入了28例CHF患者，在CRT前（T0）和6个月后（T6）进行分析，以及15名健康对照者（HC）。通过流式细胞术评估循环中的Th17和Tc17细胞。通过实时聚合酶链反应（PCR）对IL-17A mRNA表达进行定量。

结果

接受CRT的CHF患者循环中的Tc17细胞倾向于高于HC（0.92%（0.24 - 3.32）对0.60%（0.09 - 3.68）），尽管未达到统计学意义。CRT后CHF患者中Tc17细胞的频率显著降低，达到与HC相似的水平（T0时为0.92%（0.24 - 3.32），T6时为0.56%（0.21 - 4.20），P < 0.05），主要是由于CRT的反应者。此外，在T0时少数反应者患者中检测到IL-17 mRNA表达（27%），而在T6时仅在一名反应者中检测到（7%）。相反，在无反应者中，表现出IL-17 mRNA表达的患者比例从基线（17%）增加到T6时（42%）。在HC、T0时的CHF患者和T6时的患者之间，Th17细胞未观察到显著差异。