β受体阻滞剂对急性冠脉综合征Th17/Treg的作用研究  

Beta-blockers decreases Th17/Treg cytokine ratios by down regulation of GRK2 synthesis in lymphocytes of patients with ACS

作　　者：田秀青[1] 王清[1] 葛庆玲[2] 

机构地区：[1]山东省千佛山医院心内科,济南250014 [2]山东省人民政府机关医院

出　　处：《中国临床实用医学》2016年第3期16-19,共4页China Clinical Practical Medicine

基　　金：山东省科技发展计划项目资助（2012YD18051）

摘　　要：目的：探讨β受体阻滞剂对急性冠脉综合征（ACS）患者淋巴细胞G蛋白偶联受体激酶2（GRK2）和Th17/Treg的作用及意义。方法选择2013年2月至2015年12月千佛山医院心内科收治的CHD患者104例以及非CHD住院患者35例（NCA组）作为研究对象。ACS患者随机分为美托洛尔和卡维地洛治疗组。流式细胞仪测定淋巴细胞IL-17和Foxp3水平，酶联免疫吸附法测定GRK2水平。随访6个月。结果 ACS患者GRK2及IL-17/Foxp3比值均较非冠心病组明显升高（P〈0.01）。治疗6个月后，GRK2及IL-17/FoxP3比值较治疗前均明显下降（P〈0.01），两种方法比较差异无统计学意义（P〉0.05）。GRK2与IL-17/FoxP3比值呈显著正相关（P〈0.01）。结论 ACS患者Th17/Treg失调与GRK2升高有关。β受体阻滞剂可降低GRK2水平，改善Th17/Treg平衡，具有免疫调节作用。Objective To observe the effects of g protein-coupled receptor kinase-2 （GRK2） in peripheral lymphocytes on Th17/Treg cytokine ratios and investigate the potential impact and mechanism of beta-blockers on immune function in patients with acute coronary syndrome （ACS）. Methods One hundred-four patients with ACS and forty-five normal coronary angiography （NCA） hospitalized patients as control group were enrolled in the study. ACS group was randomly divided into metoprolol group（n=52） and carvedilol group（n=52）.The levels of lymphocyte GRK2 were detected by means of a sensitive sandwich enzyme-linked immunosorbent assay （ELISA） and IL-17 and FoxP3 in lymphocytes using flow cytometry at baseline and 6 months after the treatment. Results The levels of lymphocyte GRK2 and Th17/Treg in ACS patients were significantly higher than those of the UCA controls （both P〈0.01）. Multiple regression analysis confirmed that the lymphocyte GRK2 level was positively correlated with Th17/Treg ratio （P〈0.01）. After 6 months treatment of MET and CAR, lymphocyte GRK2 and Th17/Treg ratio in the ACS patients were dramatically decreased （P〈0.01）. There was no significant difference between the therapies of carvedilol and metoprolol （P〉0.05）. Conclusion These results suggest that the increase of GRK2 may affect GRK2 in peripheral lymphocytes of ACS. Beta-blockers appear to have a beneficial effect on the Th17/Treg balance of immune system through decreasing activities of GRK2.

关 键 词：急性冠脉综合征 G蛋白偶联受体激酶2 Β受体阻滞剂 TH17/TREG 

分 类 号：R541[医药卫生—心血管疾病]