Abstract
BACKGROUND: Inflammation plays important roles in the pathogenesis of acute coronary syndrome (ACS). Statins exert positive effects on the plaque stabilization through anti-inflammation, however, the detailed mechanism is still under investigation. HYPOTHESIS: Studies suggest that the Th17/Treg functional imbalance takes key part in the plaque destabilization and the onset of ACS. We hypothesized that intensive statin therapy could ameliorate the Th17/Treg imbalance in patients with ACS. METHODS: Sixty-six patients with non-ST elevation acute coronary syndrome (NSTE-ACS) were randomized to conventional group and intensive group. Peripheral blood samples were collected on admission and after atorvastatin treatment. The frequencies of circulating Th17 cells and Treg cells, the levels of cytokines associated with Th17 cells (IL-17, IL-6 and IL-23) and associated with Treg cells (IL-10 and TGF-β1) were measured through flow cytometry and ELISA assay respectively. RESULTS: One week after therapy, the frequencies of circulating Th17 cells of both the groups decreased and the frequencies of circulating Treg cells increased significantly, compared with the basal levels. Furthermore, the decreased frequencies of circulating Th17 cells and the increased frequencies of circulating Treg cells in the intensive group were significantly higher than those in the conventional group. In consistence, the decreased accumulation of IL-17, IL-6 and IL-23 (cytokines relevant to Th17 cells) and the increased accumulation of IL-10 and TGF-β1 in peripheral blood were displayed in both groups. The changes are more significant in the intensive group. CONCLUSION: Intensive statins therapy could ameliorate the Th17 and Treg functional imbalance in patients with ACS.