切换至 "中华医学电子期刊资源库"
高级检索
中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 302 -307. doi: 10.3877/cma.j.issn.1674-1366.2020.05.005

所属专题： 文献；

临床研究

慢性牙周炎伴冠心病患者Th17/Treg细胞平衡的临床意义
向文静1, 何建华2, 董贝贝1, 陈晓涛3,†()   
  1. 1. 新疆医科大学口腔医学院，乌鲁木齐　830001
    2. 新疆乌鲁木齐市口腔医院检验科，乌鲁木齐　830002
    3. 新疆维吾尔自治区人民医院口腔科，乌鲁木齐　830000
  • 收稿日期:2020-02-23 出版日期:2020-10-01
  • 通信作者: 陈晓涛

The clinical significance of Th17/Treg cell balance in chronic periodontitis patients with coronary heart disease

Wenjing Xiang1, Jianhua He2, Beibei Dong1, Xiaotao Chen3,†()   

  1. 1. Department of Stomatology, Xinjiang Medical University, Urumqi 830001, China
    2. Department of Laboratory Medicine, Xinjiang Urumqi Stomatology Hospital, Urumqi 830002, China
    3. Department of Stomatology, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
  • Received:2020-02-23 Published:2020-10-01
  • Corresponding author: Xiaotao Chen
  • About author:
    Corresponding author: Chen Xiaotao, Email:
  • Supported by:
    National Natural Science Foundation of China(81660185); Urumqi Science and Technology Project(G161310006)
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

向文静, 何建华, 董贝贝, 陈晓涛. 慢性牙周炎伴冠心病患者Th17/Treg细胞平衡的临床意义[J]. 中华口腔医学研究杂志(电子版), 2020, 14(05): 302-307.

Wenjing Xiang, Jianhua He, Beibei Dong, Xiaotao Chen. The clinical significance of Th17/Treg cell balance in chronic periodontitis patients with coronary heart disease[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2020, 14(05): 302-307.

目的

探讨慢性牙周炎伴冠心病患者外周血中辅助性T细胞17（Th17）、调节性T细胞（Treg）及Th17/Treg细胞平衡表达水平及临床意义。

方法

本研究采用2 × 2析因设计，根据冠状动脉造影结果及牙周炎诊断标准，收集2019年3—12月就诊于新疆维吾尔自治区人民医院心内科及门诊口腔科患者113例研究对象，其中健康对照组28例、单纯慢性牙周炎组26例、单纯冠心病组27例和冠心病合并慢性牙周炎组32例。流式细胞术检测外周血Th17、Treg细胞比例，计算Th17/Treg细胞比值。采用方差分析比较各组细胞比例，2 × 2析因分析探讨牙周炎和冠心病对Th17/Treg细胞平衡的交互作用。

结果

与健康对照组、慢性牙周炎组及冠心病组相比，冠心病合并慢性牙周炎组Th17细胞比例[（1.4 ± 0.6）%]显著升高，差异有统计学意义（F = 18.40，P<0.001）。与健康对照组[（8.73 ± 2.70）%]相比，冠心病合并慢性牙周炎组Treg细胞比例[（6.26 ± 2.51）%]显著降低，差异有统计学意义（F = 6.29，P = 0.001）。Th17/Treg比值在牙周炎伴冠心病组[0.221（0.317）]与健康对照组[0.055（0.054）]和慢性牙周炎组[0.119（0.115）]比较显著升高，差异有统计学意义（χ2 = 40.25，P<0.001），存在Th17/Treg失衡；析因分析表明，牙周炎与冠心病对Treg细胞水平存在交互效应（F = 3.91，P = 0.041）。

结论

牙周炎伴冠心病患者存在Th17/Treg比例失衡，且向Th17细胞偏移，表明Th17/Treg细胞平衡可能参与牙周炎伴冠心病的发生、发展。

关键词: 慢性牙周炎, 冠状动脉疾病, 辅助性T细胞17, 免疫调节T淋巴细胞
Objective

To investigate the expression levels and clinical significance of peripheral blood helper t cells 17 (Th17) , regulatory t cells (Treg) and Th17/Treg cells in chronic periodontitis patients with coronary heart disease.

Methods

In this study, 2 × 2 factorial design was used. According to outcomes of coronary angiography and the diagnostic criteria of periodontitis, a total of 113 patients with cardiology and stomatology in Xinjiang Uygur Autonomous Region People′s Hospital from March to December 2019 were collected, including 28 healthy control group, 26 chronic periodontitis group, 27 coronary heart disease group and 32 coronary heart disease combined with chronic periodontitis group. The proportion of Th17 and Treg cells in peripheral blood was detected by flow cytometry, and the ratio of Th17/Treg cells was calculated. Variance analysis was used to compare the cell proportion of each group, and 2 × 2 factorial analysis was used to explore the interaction between periodontitis and coronary heart disease on Th17/Treg cell balance.

Results

The imbalance of Th17/Treg was found in the peripheral blood of the patients with coronary heart disease and chronic periodontitis. The proportion of circulating Thl7 cell level was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group, chronic periodontitis group and coronary heart disease group (F = 18.40, P<0.001) . The proportion of circulating Treg cell level was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group (F = 6.29, P = 0.001) .The ratio of Thl7/Treg was significantly higher in coronary heart disease combined with chronic periodontitis group than in healthy control group and chronic periodontitis group (χ2 = 40.25, P<0.001) . The factorial analysis demonstrated the effect of periodontitis on Treg cell level in patients with coronary heart disease (F = 3.91, P = 0.041) .

Conclusions

The imbalance of Th17/Treg ratio in patients with periodontitis and coronary heart disease and deviated to Th17 cells indicate that Th17/Treg cell balance may participate in the occurrence and development of periodontitis and coronary heart disease.

Key words: Chronic periodontitits, Coronary disease, Th17 cells, T-lymphocytes, regulatory
图1 流式细胞仪分析四组患者外周血Th17细胞比例
图2 流式细胞仪分析四组患者外周血Treg细胞比例
表1 各组外周血Th17、Treg细胞比例及Th17/Treg比值的统计学结果
组别 例数 Th17（%, ± s) Treg（%, ± s) Th17/Treg[中位数（四分位数间距）]
健康对照组 28 0.51 ± 0.24abc 8.73 ± 2.70 0.055(0.054)
慢性牙周炎组 26 0.82 ± 0.43cd 7.18 ± 2.85d 0.119(0.115)cd
冠心病组 27 1.02 ± 0.54cd 5.74 ± 3.04d 0.185(0.336)d
牙周炎伴冠心病组 32 1.4 ± 0.6abd 6.26 ± 2.51d 0.221(0.317)ad
检验值 ? F = 18.40 F = 6.29 χ2=40.25
P值 ? <0.001 <0.001 <0.001
图3 牙周炎和冠心病对于Th17/Treg细胞水平影响交互示意图　A：Th17细胞；B：Treg细胞
[1]
Bartova J, Sommerova P, Lyuyami Y，et al. Periodontitis as a risk factor of atherosclerosis[J]. J Immunol Res，2014，2014: 636893. DOI: 10.1155/2014/636893.
[2]
Kleinewietfeld M, Hafler DA. The plasticity of human Treg and Th17 cells and its role in autoimmunity[J]. Semin Immunol，2013，25(4): 305-312. DOI: 10.1016/j.smim.2013.10.009.
[3]
Nalbant A, Eskier D. Genes associated with T helper 17 cell differentiation and function[J]. Front Biosci（Elite Ed），2016，8(3): 427-435. DOI: 10.2741/e777.
[4]
Miao C, Wang Z, Yang J，et al. Expression and mutation analysis of Cyclin A and Ki-67 in glioma and their correlation with tumor progression[J]. Oncol Lett，2015，10(3): 1716-1720. DOI: 10.3892/ol.2015.3474.
[5]
王君，王学良，席新龙. Th17细胞和Treg及相关细胞因子在自身免疫性肝炎患者外周血中的表达[J].医学临床研究，2017，34(4): 812-814. DOI: 10.3969/j.issn.1671-7171.2017.04.065.
[6]
马蕾，高梅兰，舒春梅，等. Notch1信号通路调控银屑病模型小鼠Th17细胞分化和功能[J].中国免疫学杂志，2017，33(7): 985-990. DOI: 10.3969/j.issn.1000-484X.2017.07.006.
[7]
Wacleche VS, Landay A, Routy JP，et al. The Th17 lineage：from barrier surfaces homeostasis to autoimmunity，cancer，and HIV-1 pathogenesis[J]. Viruses，2017，9(10): E303. DOI: 10.3390/v9100303.
[8]
Hansson GK, Jonasson L. The discovery of cellular immunity in the atherosclerotic plaque[J]. Arterioscler Thromb Vasc Biol，2009，29(11): 1714-1717. DOI: 10.1161/ATVBAHA.108.179713.
[9]
Libby P, Okamoto Y, Rocha VZ，et al. Inflammation in atherosclerosis：transition from theory to practice[J]. Circ J，2010，74(2): 213-220. DOI: 10.1253/circj.CJ-09-0706.
[10]
李爽，易根云，李志强，等.牙周炎与冠心病之间联系机制的研究进展[J].口腔医学研究杂志，2017，33(4): 455-458. DOI: 10.13701/j.cnki.kqyxyj.2017.04.027.
[11]
Rodrigues PH, Reyes L, Chadda AS，et al. Porphyromonas gingivalis strain specific interactions with human coronary artery endothelial cells：a comparative study[J]. PLoS One，2012，7(12): e52606. DOI: 10.1371/journal.pone.0052606.
[12]
Armitage GC, Wu Y, Wang HY，et al. Low prevalence of a periodontitis-associated interleukin-1 composite genotype in individuals of Chinese heritage[J]. J Periodontol，2000，71(2): 164-171. DOI: 10.1902/jop.2000.71.2.164.
[13]
任仪鹏，步荣发，张蕾，等.口腔鳞癌患者外周血及肿瘤微环境中Th17细胞水平研究[J].中华老年口腔医学杂志，2017，15(1): 5-8. DOI: 10.3969/j.issn.1672-2973.2017.01.002.
[14]
史悦怡，任仪鹏，张蕾，等.口腔鳞癌患者外周血及肿瘤微环境中Treg水平关系的研究[J].中华老年口腔医学杂志，2017，15(2): 77-81. DOI: 10.3969/j.issn.1672-2973.2017.02.004.
[15]
Hung HC, Willett W, Merchant A，et al. Oral health and peripheral arterial disease[J]. Circulalion，2003，107(8): 1152-1157. DOI: 10.1161/01.CIR.0000051456.68470.C8.
[16]
Qi Y, Feng W, Song A，et al. Role of serum IL-23/1L-17 axis in the relationship between periodontitis and coronary heart disease [J]. Int J Periodontics Restorative Dent，2012，33(2): 185-191. DOI: 10.11607/prd.1327.
[17]
Yang J, Wu J, Liu Y，et al. Porphyromonas gingivalis Infection Reduces Regulatory T Cells in Infected Atherosclerosis Patients [J]. PloS One，2014，9(1): e86599. DOI: 10.1371/journal.pone.0086599.
[18]
李宝坤，陈晓涛，杨柯，等.慢性牙周炎患者外周血CD4+ CD25+调节性T细胞表达[J].中华实用诊断与治疗杂志，2019，33(5): 487-490. DOI: 10.13507/j.issn.1674-3474.2019.05.021.
[19]
王琳源，关宁，林晓萍.辅助性T17细胞在牙周炎小鼠中的免疫状态研究[J].华西口腔医学杂志，2015，33(2): 125-129. DOI: 10.7518/hxkq.2015.02.004.
[20]
王琳源，关宁，林晓萍. Treg细胞介导的免疫应答在牙周炎小鼠中的研究[J].实用口腔医学杂志，2015，31(3): 318-322. DOI: 10.7518/hxkq.2015.02.004.
[21]
张勇，陈彦波.急性冠状动脉综合征患者外周血辅助性T细胞和调节性T细胞的检测意义[J].中华老年心脑血管病杂志，2016，18(9): 925-929. DOI: 10.3969/j.issn.1009-0126.2016.09.008.
[22]
Mattila KJ, Nieminen MS, Valtonen VV，et al. Association between dental health and acute myocardial infarction[J]. BMJ，1989，298(6676): 779-781. DOI: 10.1136/bmj.298.6676.779.
[23]
Chen D, Huang X, Yang M, et a1. Treg/Thl7 funetional disequilibrium in Chinese uremia on hemodialysis：a link between calcification and cardiovascular disease[J]. Ren Fail，2012，34(6): 697-702. DOI: 10.3109/0886022X.2012.672155.
[24]
Garlet GP, Cardoso CR, Mariano FS，et al. Regulatory T cells attenuate experimental periodontitis progression in mice[J]. J Clin Periodontal，2010，37(7): 591-600. DOI: 10.1111/j.1600-051X.2010.01586.x.
[25]
丁畅，黄进，陆治平，等.调节性T细胞在冠心病与牙周炎相互关系中的作用[J].中国循证心血管医学杂志，2015，7(3): 309-312. DOI: 10.3969/j.1674-4055.2015.03.06
[1] 张源祥, 邱银汝, 梁志尧, 谢微, 刘福秀, 陈铭, 苏艳芳, 王茹, 傅宴. 三磷酸腺苷和多巴酚丁胺负荷超声造影在冠心病诊断中的对比研究[J]. 中华医学超声杂志（电子版）, 2020, 17(04): 335-340.
[2] 张源祥, 邱银汝, 梁志尧, 谢微, 刘福秀, 陈铭, 苏艳芳, 王茹, 傅宴. 多巴酚丁胺负荷超声造影诊断冠心病的初步研究[J]. 中华医学超声杂志（电子版）, 2020, 17(04): 327-334.
[3] 孙亚慧, 李甜甜. 在重症急性胰腺炎患者继发感染中调节性T细胞/辅助性T细胞17失衡的机制研究[J]. 中华危重症医学杂志(电子版), 2023, 16(06): 475-480.
[4] 吴聪聪, 李开军, 徐剑, 林莉. 绝经后女性冠状动脉钙化患者的相关危险因素分析[J]. 中华危重症医学杂志(电子版), 2022, 15(02): 118-121.
[5] 周忠琴, 文凌仪, 郭应坤. 川崎病患儿冠状动脉微循环功能评估及其临床应用研究现状[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(06): 621-626.
[6] 刘康凯, 姚光辉. 补肺纳肾汤对COPD稳定期患者肺功能及外周血Treg、Th17细胞比率的影响[J]. 中华肺部疾病杂志(电子版), 2023, 16(03): 376-378.
[7] 孙文博, 连汝静. Th17/Treg水平对脑卒中并发肺部感染的临床分析[J]. 中华肺部疾病杂志(电子版), 2021, 14(03): 341-343.
[8] 党维婧, 郭桂芳. 结构化治疗与教育课程对血液透析患者慢性牙周炎的作用[J]. 中华肾病研究电子杂志, 2022, 11(02): 67-71.
[9] 熊鑫, 邓勇志. 基于血管内超声的机器学习在冠状动脉病变中的研究进展[J]. 中华诊断学电子杂志, 2023, 11(03): 153-157.
[10] 蔺曜, 黄晓玲, 何昭霞, 牟博勇, 牟燕. 血浆同型半胱氨酸水平对女性高血压患者冠状动脉病变的预测价值[J]. 中华诊断学电子杂志, 2022, 10(01): 48-52.
[11] 宋涛. 心外膜脂肪厚度、CT值及Syntax评分与冠心病的关系[J]. 中华诊断学电子杂志, 2020, 08(04): 285-288.
[12] 马亚南, 吕滨. 冠状动脉钙化特征在心血管风险评估中的价值[J]. 中华心脏与心律电子杂志, 2022, 10(03): 171-174.
[13] 黄锦, 温静, 李佳霖, 韩丹, 刘翠华, 杨殿辉, 张洋洋. 双联抗血小板药物对溃疡性结肠炎患者的影响及处理策略[J]. 中华胃肠内镜电子杂志, 2024, 11(03): 195-199.
[14] 李翔, 刘堂盛. 奥硝唑联合牙周基础治疗老年2型糖尿病患者慢性牙周炎疗效分析[J]. 中华老年病研究电子杂志, 2023, 10(03): 39-42.
[15] 孙玉娟, 徐纯鑫, 袁静, 鄢华. 女性非阻塞性急性冠状动脉综合征的研究进展[J]. 中华脑血管病杂志(电子版), 2021, 15(01): 16-21.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号