title: Treg/Th17 functional disequilibrium in Chinese uremia on hemodialysis: a link between calcification and cardiovascular disease.
abstract: OBJECTIVE
  To investigate the correlation of the functional disequilibrium of regulatory T cells (Treg)/T-helper (Th17) cells with calcification and to explore the significance of their influence on the outcome of cardiovascular disease (CVD) in uremic patients after hemodialysis (HD).
  
  
  METHODS
  Out of 66 uremia patients, 36 patients had CVD after HD (maintenance hemodialysis (MHD) group1) and 30 patients did not have CVD (MHD group2). Twenty healthy volunteers were selected as normal control group. Peripheral blood mononuclear cells were isolated and treated with recombinant human bone morphogenetic protein-2 (rhBMP-2). Treg and Th17 frequencies were measured by flow cytometry. Forkhead/winged helix transcription factor (Foxp3) and retinoic acid receptor-related orphan receptor-γt (ROR-γt) mRNA expressions were measured by real-time quantitative polymerase chain reaction. Levels of interleukin (IL)-10 and IL-17 were detected by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  When compared with controls, rhBMP-2 upregulates Treg/Th17 functional disequilibrium in uremia patients, displaying higher Treg and Th17 frequencies, Foxp3 and ROR-γt expressions, and levels of cytokines (p < 0.05). These differences were also significant between MHD group1 and group2 (p < 0.05). It was also observed that Treg/Th17 functional disequilibrium was not only correlated with a calcification state but also consistent with the CVD.
  
  
  CONCLUSIONS
  The Treg/Th17 cell function disequilibrium might act synergistically with calcification in the high incidence of CVD after HD.
authors.affiliation: Department of Nephrology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China. 13667623530@163.com
authors.forename: Danyan
authors.initials: D
authors.lastname: Chen
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Huang
authors.forename: Mengxue
authors.initials: M
authors.lastname: Yang
authors.forename: Hua
authors.initials: H
authors.lastname: Gan
authors.forename: Evan Jim
authors.initials: EJ
authors.lastname: Gunawan
authors.forename: Weixue
authors.initials: W
authors.lastname: Tang
mesh_terms: D000704:Analysis of Variance; D055396:Bone Morphogenetic Protein 2 / Q000494:pharmacology; D002114:Calcinosis / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000378:metabolism*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D020381:Interleukin-17 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000378:metabolism; D060888:Real-Time Polymerase Chain Reaction; D018168:Receptors, Retinoic Acid / Q000378:metabolism; D011994:Recombinant Proteins / Q000494:pharmacology; D006435:Renal Dialysis; D012307:Risk Factors; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*; D058504:Th17 Cells / Q000378:metabolism*; D016212:Transforming Growth Factor beta / Q000494:pharmacology; D014511:Uremia / Q000209:etiology / Q000378:metabolism* / Q000628:therapy*
chemical_list: D055396:Bone Morphogenetic Protein 2; D051858:Forkhead Transcription Factors; D020381:Interleukin-17; D012333:RNA, Messenger; D018168:Receptors, Retinoic Acid; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; D016753:Interleukin-10