title: Effect of Th17 and Treg axis disorder on outcomes of pulmonary arterial hypertension in connective tissue diseases.
abstract: This prospective cohort study is to verify the hypothesis that the balance of Th17 and Treg cells frequencies in the peripheral circulation is disturbed in patients with varying degrees of connective tissue diseases-associated pulmonary arterial hypertension (CTD-aPAH) and to prove the influence of Th17/Treg imbalance on prognosis. We detected the frequencies and absolute counts of Th17 and Treg cells and related serum cytokines secretion and expressions of key transcription factors in 117 patients with connective tissue diseases (CTD), 53 patients with CTD-aPAH, and 48 healthy volunteers. Moreover, the median value according to levels of Th17/Treg ratios in patients with CTD-aPAH was chosen as basis of group division for survival analysis. CTD-aPAH patients revealed significant increase in peripheral Th17 cells, Th17-related cytokines, and ROR γt mRNA levels. They also presented a significant decrease in Treg cells, Treg-related cytokines, and Foxp3 mRNA levels as compared with CTD patients and healthy controls. More importantly, the Th17/Treg ratio was significantly related to the severity and prognosis of CTD-aPAH. This study indicated that the Th17/Treg axis disorder plays a critical role in CTD-aPAH. Furthermore, the dynamic balance between Th17 and Treg cells was likely to influence prognosis of patients with CTD-aPAH.
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Saren
authors.identifier: 0000-0003-4620-0860
authors.initials: S
authors.lastname: Gaowa
authors.affiliation: Department of Cardiothoracic Surgery, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Wenyong
authors.identifier: 0000-0001-9261-025X
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Lilei
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Cardiothoracic Surgery, East Hospital, Tongji University, Shanghai 200120, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Kai
authors.identifier: 0000-0002-6045-4595
authors.initials: K
authors.lastname: Liao
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Zhibin
authors.identifier: 0000-0003-0548-0325
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
authors.forename: Hong
authors.identifier: 0000-0002-9365-0517
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
authors.forename: Xiaofeng
authors.identifier: 0000-0001-8872-8028
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003240:Connective Tissue Diseases / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D051858:Forkhead Transcription Factors / Q000235:genetics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000378:metabolism* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3 / Q000235:genetics; D011446:Prospective Studies; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*; D058504:Th17 Cells / Q000378:metabolism*; D055815:Young Adult
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D057132:Nuclear Receptor Subfamily 1, Group F, Member 3