冠心病患者外周血树突状细胞亚型分布与血浆单核细胞趋化蛋白1的关系

目的探讨冠心病患者外周血树突状细胞(DCs)亚型分布与血浆单核细胞趋化蛋白1(MCP-1)浓度变化的关系。方法连续入选2010年11月～2011年12月在我院心内科住院经冠状动脉造影术检查及治疗的患者(稳定型心绞痛10例、不稳定型心绞痛25例以及急性心肌梗死25例)60例,正常对照组28例。采用流式细胞仪四色荧光标记技术对外周血髓样树突状细胞(mDCs)和浆细胞样树突状细胞(pDCs)占外周血单核细胞比例进行检测,酶联免疫吸附测定法检测外周血浆单核细胞趋化蛋白1的表达,评价各组间差异,并对外周血髓样树突状细胞与外周血浆MCP-1进行相关性分析。结果急性心肌梗死组和不稳定型心绞痛组组mDCs占外周血单核细胞比例及mDCs实际数量明显低于对照组和稳定型心绞痛组(P<0.001);冠心病患者外周血浆MCP-1浓度明显高于正常人(P<0.001),并且与外周血mDCs比例呈负相关(r=-0.707,P<0.001)。结论 MCP-1可能促进了冠心病患者外周血mDCs向AS斑块病变部位迁徙并介导了斑块局部免疫炎症反应,加剧了AS斑块的不稳定。

Peripheral dendritic cell subsets and changes in plasma monocyte chemoattractant protein 1 in patients with coronary heart disease

Objective To assess the association between peripheral blood dendritic cells subtype distribution and plasma monocyte chemoattractant protein 1(MCP-1) concentration in patients with coronary heart disease(CHD).Methods Sixty consecutive CHD patients admitted in our department during the period from November,2010 to December,2011 were enrolled,including 10 with stable angina pectoris(SAP),25 with unstable angina pectoris(UAP),and 25 with acute myocardial infarction(AMI),with 28 healthy volunteers as normal controls.All the subjects underwent routine tests and coronary angiography.The percentages of peripheral blood myeloid dendritic cells(mDCs) and plasma cell-like dendritic cells(pDCs) in peripheral blood mononuclear cells were detected by flow cytometry,and plasma MCP-1 levels were detected using enzyme-linked immunosorbent assay.Results The percentage and absolute quantity of mDCs and pDCs were significantly lower in AMI and UAP groups than in the normal control and SAP groups(P<0.001).In the CHD patients,the plasma MCP-1 level was significantly higher than that in the normal control group(P<0.001) with an inverse correlation with the percentage of peripheral mDCs.Conclusion MCP-1 may promote the migration of mDCs into atherosclerotic plaques and mediate the local immune and inflammatory responses to aggravate plaque instability in CHD patients.