Department of Rheumatology, The Second Hospital of Shanxi Medical University, Shanxi, 030000, Taiyuan, China.
Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
BMC Immunol. 2021 Dec 16;22(1):76. doi: 10.1186/s12865-021-00466-0.
To identify lymphocyte and CD4 + T cell subset characteristics, particularly regulatory T cells (Tregs), in active rheumatoid arthritis (RA) patients with coronary artery disease (CAD).
A total of 54 RA patients with CAD (RA-CAD group), 43 RA patients without CAD (pure RA group), and 43 healthy controls (HC group) were enrolled. The absolute number and frequency of lymphocyte subpopulations and CD4 + T cell subsets were analyzed by flow cytometry. Serum levels of cytokines were analyzed using a cytometric bead array. Clinical and laboratory data were collected retrospectively and their correlation with CD4 + T subsets were analyzed.
There was a significant decrease in the absolute number of Treg cells (CD4 + CD25 + Foxp3 + T cells) in the RA-CAD group compared to the pure RA group (p < 0.001). Similarly, both the absolute number (p = 0.001) and frequency (p = 0.011) of Tregs in the RA-CAD group were decreased compared to the HCs, causing a Th17/Treg imbalance (p = 0.044). No difference was found in the absolute number and frequency of Treg cells between the pure RA and HC groups. However, the absolute Th17 cell count was increased in the pure RA group (p = 0.032). The serum level of cytokine IL-17 was lower in the RA-CAD group than in the pure RA group (p = 0.023). In the RA-CAD group, the Treg number was negatively correlated with the RA disease activity score and ESR value, and LDL and ApoB100 levels were negatively correlated with the number of Th17 cells.
Active RA patients with CAD sustain more severe immune tolerance damage and Th17/Treg disorder. Monitoring of lymphocyte and CD4 + T cell subsets, particularly Treg cells, is crucial to understanding immune status in this group. Focusing on RA activity and CAD risk control, immune-regulatory therapy based on the Treg level may be more beneficial for RA patients with CAD.
鉴定活动性类风湿关节炎（RA）合并冠状动脉疾病（CAD）患者的淋巴细胞和 CD4+T 细胞亚群特征，尤其是调节性 T 细胞（Treg）。
共纳入 54 例 RA 合并 CAD（RA-CAD 组）、43 例 RA 不合并 CAD（单纯 RA 组）和 43 例健康对照（HC 组）。采用流式细胞术分析淋巴细胞亚群和 CD4+T 细胞亚群的绝对数和频率。采用细胞因子荧光微珠阵列分析法检测血清细胞因子水平。回顾性收集临床和实验室数据，并分析其与 CD4+T 细胞亚群的相关性。
与单纯 RA 组相比，RA-CAD 组 Treg 细胞（CD4+CD25+Foxp3+T 细胞）的绝对数显著减少（p<0.001）。同样，RA-CAD 组 Treg 的绝对数（p=0.001）和频率（p=0.011）均低于 HC 组，导致 Th17/Treg 失衡（p=0.044）。单纯 RA 组和 HC 组之间 Treg 细胞的绝对数和频率无差异。然而，单纯 RA 组的 Th17 细胞绝对计数增加（p=0.032）。RA-CAD 组的细胞因子 IL-17 血清水平低于单纯 RA 组（p=0.023）。在 RA-CAD 组，Treg 数量与 RA 疾病活动评分和 ESR 值呈负相关，LDL 和 ApoB100 水平与 Th17 细胞数量呈负相关。
活动性 RA 合并 CAD 患者的免疫耐受损伤更严重，Th17/Treg 失衡更明显。监测淋巴细胞和 CD4+T 细胞亚群，尤其是 Treg 细胞，对于了解该人群的免疫状态至关重要。关注 RA 活动和 CAD 风险控制，基于 Treg 水平的免疫调节治疗可能对 RA 合并 CAD 患者更有益。
