title: Effect of immune modulation therapy on cardiac function and T-bet/GATA-3 gene expression in aging male patients with chronic cardiac insufficiency.
abstract: OBJECTIVE
  The aim of this study was to explore the role of immune modulation therapy in regulating the imbalance of Th1/Th2, serum IFN-γ, IL-4 and the T-cell-specific transcription factors T-bet/GATA-3 in peripheral blood in aging male patients with chronic cardiac insufficiency (CCI).
  
  
  METHODS
  In total, 156 participants were divided into three groups: the CCI intervention group, which received regular therapy and thymopetidum (20 mg intramuscular injection, once every other day for 3 months; n = 70), the CCI control group, which received regular therapy (n = 56) and 50 healthy individuals older than 57 years of age, who served as normal controls.
  
  
  RESULTS
  Before therapy, in comparison with the control group, levels of left ventricular end diastolic diameter, NT-proBNP, C-reactive protein (CRP), Th1, Th1/Th2, IFN-γ, and T-bet mRNA and T-bet/GATA-3 mRNA all increased, and the level of left ventricular ejection fraction (LVEF), 6MWT, Th2, IL-4, and GATA-3 mRNA also decreased in both the CCI intervention and control groups. Linear correlation analysis indicated that LVEF was inversely correlated with serum NT-proBNP, CRP, Th1/Th2, IFN-γ and T-bet mRNA/GATA-3 mRNA, and was positively correlated with plasma IL-4. After 3 months of therapy, levels of left ventricular end diastolic diameter, NT-proBNP, CRP, Th1, Th1/Th2, IFN-γ, T-bet mRNA and T-bet/GATA-3 mRNA decreased in the two CCI subgroups, but levels in the CCI intervention group were lower in comparison to the control group. Levels of LVEF, 6MWT, Th2 and GATA-3 mRNA increased in the two CCI subgroups, while levels in the CCI intervention group were higher in comparison with the control group. Plasma levels of IL-4 showed no change after treatment.
  
  
  CONCLUSIONS
  Immune modulation improved cardiac function of CCI patients and was associated with amelioration of T-helper superficial transcription factor polarization and its related cytokine imbalance. Immune modulation might be a new treatment strategy for aging CCI patients.
authors: First Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Number 28 Fuxing Road, Haidian District, Beijing 100853, China.
authors: Li-Na
authors: LN
authors: Han
authors: Shu-Li
authors: SL
authors: Guo
authors: Tie-Ling
authors: TL
authors: Li
authors: Guo-Lei
authors: GL
authors: Ding
authors: Ya-Jing
authors: YJ
authors: Zhang
authors: Jin-Ling
authors: JL
authors: Ma
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002908:Chronic Disease; D004452:Echocardiography; D005434:Flow Cytometry; D050990:GATA3 Transcription Factor / Q000235:genetics*; D015870:Gene Expression / Q000187:drug effects; D006333:Heart Failure / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012333:RNA, Messenger / Q000097:blood / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D020825:T-Box Domain Proteins / Q000235:genetics*; D018417:Th1 Cells / Q000187:drug effects / Q000378:metabolism; D018418:Th2 Cells / Q000187:drug effects / Q000378:metabolism; D016305:Thymopentin / Q000008:administration & dosage*; D016896:Treatment Outcome; D000098815:T-bet Transcription Factor
chemical_list: D000276:Adjuvants, Immunologic; D050990:GATA3 Transcription Factor; D010446:Peptide Fragments; D012333:RNA, Messenger; D020825:T-Box Domain Proteins; D000098815:T-bet Transcription Factor; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D015847:Interleukin-4; D007371:Interferon-gamma; D002097:C-Reactive Protein; D016305:Thymopentin