First Clinical Medical School, Lanzhou University, Lanzhou, China.
Emergency Medical Center, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, China.
J Clin Hypertens (Greenwich). 2024 Apr;26(4):431-440. doi: 10.1111/jch.14784. Epub 2024 Mar 24.
We measured the levels of High-Mobility Group Box 1 (HMGB1), Receptor for Advanced Glycation Endproducts (RAGE), T Helper 17 cells (Th17), Regulatory T cells (Treg), and related cytokines in the peripheral blood of patients with severe preeclampsia (SPE) complicated with acute heart failure (AHF) to explore the expression changes in these indicators. In total, 96 patients with SPE admitted to Gansu Provincial Maternity and Child-care Hospital between June 2020 and June 2022 were included in the study. The patients were divided into SPE+AHF (40 patients) and SPE (56 patients) groups based on whether they suffered from AHF. Additionally, 56 healthy pregnant women who either received prenatal examinations or were admitted to our hospital for delivery during the same period were selected as the healthy control group. An enzyme-linked immunosorbent assay was performed to detect the expression levels of HMGB1, RAGE, interleukin (IL)-17, IL-6, transforming growth factor β (TGF-β), IL-10, and NT-proBNP in plasma. Flow cytometry was employed to determine the percentages of Th17 and Treg cells. Compared to the healthy control group, the SPE+AHF and SPE groups had higher plasma levels of HMGB1 and RAGE expression, higher Th17 percentage and Th17/Treg ratio, and lower Treg percentage. Compared to the SPE group, the SPE+AHF group had higher plasma levels of HMGB1 and RAGE expression, higher Th17 percentage and Th17/Treg ratio, and lower Treg percentage (P < .05). In patients with SPE with AHF, plasma HMGB1 was positively correlated with RAGE, Th17, Th17/Treg, IL-17, and IL-6 and was negatively correlated with TGF-β and IL-10 (P < .05). Our findings revealed that patients with SPE with AHF had elevated levels of HMGB1 and RAGE while exhibiting Th17/Treg immune imbalance, suggesting that the abnormal expression of these indicators may be involved in the pathogenesis of SPE with AHF.
我们测量了严重先兆子痫（SPE）合并急性心力衰竭（AHF）患者外周血中高迁移率族蛋白 B1（HMGB1）、晚期糖基化终产物受体（RAGE）、辅助性 T 细胞 17（Th17）、调节性 T 细胞（Treg）和相关细胞因子的水平，以探讨这些指标的表达变化。共纳入 2020 年 6 月至 2022 年 6 月甘肃省妇幼保健院收治的 96 例 SPE 患者，根据是否合并 AHF 将患者分为 SPE+AHF（40 例）和 SPE（56 例）组。另选同期在我院产检或住院分娩的 56 例健康孕妇作为健康对照组。采用酶联免疫吸附法检测血浆中 HMGB1、RAGE、白细胞介素（IL）-17、IL-6、转化生长因子-β（TGF-β）、IL-10、NT-proBNP 的表达水平，流式细胞术检测 Th17、Treg 细胞的百分比。与健康对照组比较，SPE+AHF 组和 SPE 组血浆 HMGB1、RAGE 表达水平升高，Th17 细胞百分比及 Th17/Treg 比值升高，Treg 细胞百分比降低；与 SPE 组比较，SPE+AHF 组血浆 HMGB1、RAGE 表达水平升高，Th17 细胞百分比及 Th17/Treg 比值升高，Treg 细胞百分比降低（P<0.05）。SPE 合并 AHF 患者血浆 HMGB1 与 RAGE、Th17、Th17/Treg、IL-17、IL-6 呈正相关，与 TGF-β、IL-10 呈负相关（P<0.05）。SPE 合并 AHF 患者存在 HMGB1、RAGE 升高及 Th17/Treg 免疫失衡，提示这些指标的异常表达可能参与 SPE 合并 AHF 的发病机制。
