title: [Analysis of changes in percentage of phenotype CD4 + CD45RA + and CD4+ CD45RO + in peripheral blood and effect of immunomodulation in aged male patients with chronic cardiac insufficiency].
abstract: OBJECTIVE
  Autoimmunity participates in chronic heart failure (CCI), it is CD4+ T lymphocytes that mainly induces myocardial infiltration and the progression of the disease. The purpose of this research is to assess changes of CD4+, CD8+ T lymphocyte subset, and phenotype of primary T cell (CD4+ CD45RA+) and memory T cells (CD4+ CD45RO+) in peripheral blood in aged male patients with CCI. And to investigate the immunomodulatory effects on subsets of CD4+, CD8+ and phenotype of CD4+ CD45RA+ and CD4+ CD45RO+ and the possible therapeutic mechanism.
  
  
  METHODS
  The participant were 155 aged men among whom 94 cases were diagnosed as CCI and heart function of the rest 41 cases were normal. All patients underwent echocardiography examination and were collected peripheral blood before and after treatment. Serum N terminal pro-brain natriuretic peptide (NT-proBNP) levels were detected by heterogeneous immunoassay. Serum C reactive protein (CRP) were measured by immunoturbidimetry assay. T lymphocytes in peripheral blood were separated and determined distribution of CD4+, CD8+, CD4+ CD45RA+, CD4+ CD45RO+ using flow cytometry. Participants were divided into 3 groups: the CCI intervention group, who received regular therapy and thymopentin (20 mg intramuscular injection, once every other day for 3 month; n = 60) , the CCI control group, who received regular therapy (n = 54) and 41 healthy individual older than 57 years of age, who served as normal controls.
  
  
  RESULTS
  Compared with the control group, left ventricular ejection fraction (LVEF) and CD4+ CD45RO+ levels decreased, left ventricular end diastolic diameter (LVEDD), NT-proBNP, CRP, CD4+, CD4+ CD45RA+, CD4+/CD8+, CD4+ CD45RA+/CD4+ CD45RO+ levels were obviously higher in CCI group. Distribution of CD8+ was not significantly changed. The level of NT-proBNP, CRP, CD4+/CD8+, CD4+ CD45RA+/CD4+ CD45 RO+ was negatively correlated with LVEF. LVEF could be much improved via decreasing distribution of CD4+/CD8+, CD4+ CD45RA+/CD4+ CD45RO in CCI intervention group than in CCI control group.
  
  
  CONCLUSIONS
  The changes of CD4+/CD8+ and CD4+ CD45RA+/CD4+ CD45RO+ suggest that CD4+ T lymphocyte subset and its phenotype play an important role in the process of CCI. The regulation of CD4+ T lymphocyte and its phenotype may be one of the strategy in the treatment of CCI.
authors.affiliation: Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Sanya 572014, China.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Han
authors.affiliation: Department of Cardiology, Chinese PLA 187 Center Hospital, Hainan 571159, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Lin
authors.affiliation: Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Sanya 572014, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Sanya 572014, China.
authors.forename: Chuan-Bo
authors.initials: CB
authors.lastname: Zang
authors.affiliation: Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Sanya 572014, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Yang
authors.affiliation: Department of Geriatric Cardiology Internal Medicine, Chinese PLA General Hospital, Sanya 572014, China.
authors.forename: Guo-Lei
authors.initials: GL
authors.lastname: Ding
authors.affiliation: Department of Cardiology, Chinese PLA 187 Center Hospital, Hainan 571159, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Peng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes; D018414:CD8-Positive T-Lymphocytes; D006333:Heart Failure / Q000097:blood* / Q000276:immunology*; D006801:Humans; D056747:Immunomodulation; D017493:Leukocyte Common Antigens / Q000276:immunology; D008297:Male; D010641:Phenotype; D016176:T-Lymphocyte Subsets / Q000276:immunology*
chemical_list: D017493:Leukocyte Common Antigens