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目的树突状细胞(Dendritic cell,DC)是目前发现的功能最强的专职性抗原提呈细胞(APC)。近年来研究发现,DC参与动脉粥样硬化(AS)的免疫炎性反应过程。人外周循环中主要有两类DC:髓样树突细胞(mDC)和浆细胞样树突关细胞(pDC),在自身免疫系统疾病中外周血DC数量明显下降。本课题主要研究急性ST段抬高型心肌梗死患者外周血mDC和pDC数量的变化。方法入选17例ST段抬高型急性心肌梗死患者,14例冠状动脉造影证实的稳定型心绞痛患者,以及性别、年龄相匹配的15例冠状动脉造影证实的健康对照人群。采用流式细胞仪三色分析测定③组人群中外周血DC数量及其亚型的绝对数和比例,其中ST段抬高型心肌梗死患者在发作后7 d进行随访。结果ST段抬高型心肌梗死患者mDC与pDC占外周血单个核细胞的比值及其绝对值较正常对照组和稳定型心绞痛患者组均明显下降(P值均<0．01)。急性心肌梗死组、健康对照组及稳定型心绞痛组中,mDC占外周血单个核细胞的百分比分别为(0．037±0．035)％, (0．229±0．015)％和(0．223±0．016)％,③组中mDC的绝对数分别为(3．78±0．85)μL、(14．84±0．97)μL和(14．5±1．34)μL,pDC所占比例分别为(0．018±0．023)％、(0．056±0．006)％和(0．039±0．005)％,绝对数分别为(1．51±0．46)μL、(3．29±0．31)μL、(12．25±0．36)μL,稳定型心绞痛组与健康对照组间外周血mDC所占比例比较,差异无统计学意义,外周血中pDC所占比例明显下降(P<0．05)。在急性心肌梗死组,mDc及pDC所占百分比及绝对数在心肌梗死后1周明显增高(P值均<0．05)。结论与自身免疫系统疾病外周血DC数量下降相似,急性心肌梗死时外周血mDC及pDC在急性期明显降低,1周后明显上升。提示在心肌梗死急性期外周血DC数量明显下降可能参与斑块不稳定的形成,但其具体机制还需进一步研究。
Objective Dendritic cells (DCs) are the most potent and specialized antigen-presenting cells (APCs) found so far. Recent studies have found that DC is involved in the immune inflammatory reaction of atherosclerosis (AS). There are mainly two types of DCs in human peripheral circulation: myeloid dendritic cells (mDC) and plasmacytoid dendritic cells (pDC), which have a marked decrease in the number of peripheral blood DCs in autoimmune system diseases. This topic focuses on the changes of the number of mDC and pDC in peripheral blood of patients with acute ST-segment elevation myocardial infarction. Methods Seventeen patients with ST-segment elevation acute myocardial infarction, 14 patients with stable angina pectoris confirmed by coronary angiography, and 15 healthy and matched controls confirmed by coronary angiography. Using flow cytometry three-color analysis to determine the number of peripheral blood DC in the group of patients and the absolute number and proportion of their subtypes, ST-segment elevation myocardial infarction patients were followed up 7 days after the onset. Results The ratio of mDC and pDC to peripheral blood mononuclear cells in patients with ST-segment elevation myocardial infarction was significantly lower than that in normal controls and patients with stable angina (all P <0.01). The percentages of mDC in peripheral blood mononuclear cells in acute myocardial infarction group, healthy control group and stable angina group were (0.037 ± 0.035)%, (0.229 ± 0.015)% and (0 .223 ± 0.016)%, ③ The absolute numbers of mDC in the group were (3.78 ± 0.85) μL, (14.84 ± 0.97) μL and (14.5 ± 1.34) μL , pDC (0.018 ± 0.023)%, (0.056 ± 0.006)% and (0.039 ± 0.005)%, the absolute numbers were (1.51 ± 0 .46) μL, (3.29 ± 0.31) μL and (12.25 ± 0.36) μL, respectively. There was no significant difference in the proportion of mDC between stable angina pectoris group and healthy control group, The proportion of pDC in peripheral blood decreased significantly (P <0.05). In acute myocardial infarction group, the percentage and the absolute number of mDc and pDC were significantly increased 1 week after myocardial infarction (all P <0.05). Conclusions The number of DCs in peripheral blood is similar to that of autoimmune diseases. The levels of mDC and pDC in peripheral blood of acute myocardial infarction are significantly lower in acute phase and obviously increase in 1 week. It is suggested that the significant decrease of DC in acute myocardial infarction may be involved in the formation of plaque instability, but its specific mechanism needs further study.