title: Study on the effect and mechanism of the dysfunction of CD4(+) T cells in the disease process of chronic cardiac failure.
abstract: OBJECTIVE
  To study the effect and mechanism of the dysfunction of CD4(+) T cells in the disease process of chronic cardiac failure (CHF).
  
  
  METHODS
  According to different group technologies, 100 CHF patients were divided into the following groups: ischemia group and non-ischemia group, heart function Ⅲ-Ⅳ group and heart function Ⅰ-Ⅱ group, event group and non-event group, and 50 healthy volunteers were included in the control group. Real-time PCR was used to detect transcription factors T-bet and GATA-3 of Th1 and Th2; flow cytometry was applied to determine the ratio of Th17 and Treg cells; ELISA was employed to test cytokines IFN-γ, IL-4, IL-17 and IL-10 of peripheral blood Th1, Th2, Th17 and Treg cells, respectively; ultrasonic cardiogram was used to exploit to LVEF and LVEDd; and electrochemilu minescene immunoassay was used to examine plasma BNP. The differences of all indexes of all groups were analyzed and the correlation between CD4 T cells and clinical indexes was analyzed by Pearson correlation analysis.
  
  
  RESULTS
  As compared to the control group, the transcription factors T-bet and GATA-3 of Th1 and Th2, the ratio of cytokines Th17 and IFN-γ, cytokines IL-17, T-bet/GATA-3, IFN-γ/IL-4, Th17 cells/Treg cells, IL-17/IL-10 of the ischemia group and non-ischemia group, heart function Ⅲ-Ⅳ group and heart function Ⅰ-Ⅱ group, event group and non-event group were all increased significantly, while their transcription factor GATA-3 of Th2, cytokines IL-4, Treg cells ratio, cytokines IL-10 were decreased obviously. The differences showed statistical significance (P < 0.05). The increase or decrease of the partial CD4+ T cells of the ischemia group, heart function Ⅲ-Ⅳ group and event group was more distinctly. The results of Pearson correlation analysis showed that IFN-γ and IL-17 were significantly positively correlated with LVEDd and BNP, IL-4 and IL-10 were also significantly positively correlated with LVEF, but correlated negatively with BNP, and IL-17 was negatively correlative with LVEF.
  
  
  CONCLUSIONS
  There was a correlation between CHF and the dysfunction of CD4(+) T cells showing immune activation phenomenons of deviations from the Th1/Th2 balance towards Th1 and from the Th17/Treg balance towards Th17, which was also related to the types, severity and prognosis of the disease.
authors.affiliation: Emergency Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
authors.forename: Yin-Hao
authors.initials: YH
authors.lastname: Cai
authors.affiliation: Emergency Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
authors.forename: Zi-Jian
authors.initials: ZJ
authors.lastname: Ma
authors.affiliation: Emergency Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
authors.forename: Xiu-Ying
authors.initials: XY
authors.lastname: Lu
authors.affiliation: Emergency Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China.
authors.forename: En-Le
authors.initials: EL
authors.lastname: He
authors.affiliation: Neurology Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, Guizhou, China. Electronic address: youmingyao322@163.com.
authors.forename: Ming-Yao
authors.initials: MY
authors.lastname: You
keywords: CD4 T cells; Chronic cardiac failure; Heart function; Prognosis