Treatment with telmisartan/rosuvastatin combination has a beneficial synergistic effect on ameliorating Th17/Treg functional imbalance in hypertensive patients with carotid atherosclerosis.
OBJECTIVE
To explore synergistic effect between angiotensin II receptor blockers (ARBs) and statins on Th17/Treg functional imbalance in hypertensive patients with carotid atherosclerosis.


METHODS
This study was a 2 × 2 factorial randomized, prospective, double-blind, placebo-controlled trial. One hundred and fifty nine hypertensive patients with carotid atherosclerosis were randomized to the administration of control group, telmisartan group, rosuvastatin group, and combination group (telmisartan plus rosuvastatin) base on hydrochlorothiazide treatment. Carotid ultrasonography, parameters of Th17/Treg functional axis, interleukin (IL)-1β, IL-2, interferon (IFN)-γ, hypersensitive C-reactive protein (hsCRP), monocyte chemotactic protein (MCP)-1 were evaluated.


RESULTS
Blood pressure level markedly reduced in four groups. There was significantly synergistic effect of combination of telmisartan with rosuvastatin on reducing carotid imtima-media thickness (IMT), Th17 cells frequency, IL-17, IL-6, IL-23, tumor necrosis factor (TNF)-α, expression of retinoic acid receptor-related orphan receptor (ROR)γt mRNA, Th17/Treg ratio, IL-1β, IL-2, IFN-γ, hsCRP, and MCP-1, and increasing Treg cells frequency, IL-10, transforming growth factor(TGF)-β1, and expression of forkhead/winged helix transcription factor (Foxp3) mRNA (all P<0.05). Change rate of IMT statistical positively related to descent rates of Th17 cells frequency, IL-17, IL-6, IL-23, TNF-α, expression of RORγt mRNA, Th17/Treg ratio, IL-1β, IL-2, IFN-γ, hsCRP, and MCP-1, and negatively related to increased rates of Treg frequency, IL-10, TGF-β1, and expression of Foxp3 mRNA, respectively (all P<0.05).


CONCLUSIONS
There is a synergistic effect of combination of telmisartan with rosuvastatin on ameliorating Th17/Treg functional imbalance in hypertensive patients with carotid atherosclerosis.
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China. Electronic address: zhendongliu876@126.com.
Zhendong
Z
Liu
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Yingxin
Y
Zhao
Department of Cardiology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, China.
Fang
F
Wei
Department of Cardiology, Shandong Provencial Hospital, Jinan, Shandong 250021, China.
Lin
L
Ye
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Fanghong
F
Lu
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Hua
H
Zhang
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Yutao
Y
Diao
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Hongbin
H
Song
Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, No. 18877, Jingshi Road, Jinan, Shandong 250062, China.
Zaiwen
Z
Qi
D000328:Adult; D000368:Aged; D001562:Benzimidazoles / Q000008:administration & dosage*; D001565:Benzoates / Q000008:administration & dosage*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000188:drug therapy*; D059168:Carotid Intima-Media Thickness; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3 / Q000096:biosynthesis; D011743:Pyrimidines / Q000008:administration & dosage*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects*; D000077333:Telmisartan; D058504:Th17 Cells / Q000187:drug effects*
D001562:Benzimidazoles; D001565:Benzoates; D005464:Fluorobenzenes; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000077333:Telmisartan
Angiotensin II receptor blockers; Anti-inflammation; Atherosclerosis; Hypertension; Statin; Synergistic effect