Circulating CD4+CD25+ T cells in rheumatic mitral stenosis.
OBJECTIVE
Autoimmunity plays an essential role in the pathogenesis of rheumatic heart disease. Although the ongoing rheumatic process has been demonstrated with high levels of inflammatory markers, the cellular mechanism(s) of autoimmunity have not yet been investigated. The study aim was to examine levels of circulating CD4+CD25+ T cells in patients with rheumatic mitral stenosis, and to evaluate the relationship between regulatory CD4+CD25+ T-cell count and clinical and echocardiographic measures.


METHODS
A total of 42 patients with mitral stenosis was enrolled into the study, and 27 normal age- and gender-matched healthy subjects served as controls. All patients and controls underwent clinical, electrocardiographic, echocardiographic and laboratory evaluation. T-cell levels were determined with flow cytometry using monoclonal fluorescein isothiocyanate-labeled anti-CD4 and phycoerythrin-labeled anti-CD25 antibodies.


RESULTS
The circulating CD4+CD25+ T-cell count was significantly lower in patients with mitral stenosis than in controls (231 +/- 120 versus 372 +/- 180 per mm3; p = 0.001). The percentage ratio of CD4+CD25+ T cells to total leukocytes and lymphocytes was significantly lower in patients with mitral stenosis than in controls (2.9 +/- 1.5 versus 5.2 +/- 2.1; p < 0.001, and 11.2 +/- 5.6 versus 14.8 +/- 5.6; p = 0.011, respectively). In addition, a significant negative correlation was identified between the erythrocyte sedimentation rate and circulating CD4+CD25+ T-cell count (Spearman rho = -0.414; p = 0.006). No correlation was found between CD4+CD25+ T-cell count and clinical and echocardiographic parameters in patients with mitral stenosis.


CONCLUSIONS
A decrease in CD4+CD25+ T cell numbers in mitral stenosis patients might suggest a role for cellular autoimmunity in a smoldering rheumatic process.
Yildiz
Ali
A
Department of Cardiology, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey. ghcayildiz@yahoo.com
Ozeke
Ozcan
O
Aras
Dursun
D
Balci
Mustafa
M
Deveci
Bulent
B
Ergun
Kumral
K
Topaloglu
Serkan
S
Dogan
Mehmet
M
Ozcan
Firat
F
Sokmen
Yeliz
Y
Sasmaz
Ali
A
Korkmaz
Sule
S
D000328:Adult; D015551:Autoimmunity / Q000502:physiology; D051927:CD24 Antigen / Q000097:blood* / Q000235:genetics; D016022:Case-Control Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000097:blood* / Q000235:genetics; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood / Q000209:etiology / Q000276:immunology*; D012216:Rheumatic Diseases / Q000150:complications*; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology
D051927:CD24 Antigen; D053645:Interleukin-2 Receptor alpha Subunit