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Int J Clin Exp Pathol 2013;6(6):1015-1027

Original Article
Peripheral Th17/Treg imbalance in patients with atherosclerotic cerebral infarction

Qing Li, Yiping Wang, Feng Yu, Yuan Min Wang, Cuiping Zhang, Chaojie Hu, Zhiwei Wu, Xiucai Xu, Shilian Hu

The Central Laboratory of Medical Research Center, Anhui provincial Hospital, Hefei, Anhui230001, PR China; The Centre for Transplantation
and Renal Research, Western Clinical School, University of Sydney, Westmead, NSW Australia; Department of Neurology, Department of
Geriatrics, Anhui Evidence-Based Medicine Center, Anhui Geriatrics Institute, Anhui provincial Hospital, Hefei, Anhui230001, PR China; Centre
for Kidney Research, Children’s Hospital at Westmead, Sydney, NSW, Australia. These authors contributed equally to this work.

Received April 11, 2013; Accepted May 6, 2013; Epub May 15, 2013; Published June 1, 2013

Abstract: Objective: CD4+CD25+ regulatory T (Treg) cells and Th17 cells play important roles in peripheral immunity. Oxidized low-density
lipoprotein (ox-LDL) is an instrumental factor in atherogenesis. However, the changes of Th17/Treg cells in patients with acute cerebral
Infarction (ACI) and impact on Th17/Treg by ox-LDL are not clear. Here, we examined the balance of Th17/Treg in ACI patients and the effect of
ox-LDL on this balance. Materials and methods: The frequencies of Th17 and Treg cells, key transcription factors and relevant cytokines were
examined in patients with ACI, Transient ischemic attack (TIA) and controls. The correlations of cytokines, inflammatory biomarkers and ox-LDL
in serum to Th17/Treg frequency, and the effects of ox-LDL on Th17/Treg cells in vitro were analyzed. Results: ACI patients have shown a
significant increase of Th17 frequency, RORγt expression and Th17 related cytokines (IL-17 and IL-6 ) levels, and a clear decline of Treg
frequency, Foxp3 expression, suppressive function and regulatory cytokines (IL-10 and TGF-β1) levels. Furthermore, TIA patients also have
notable variation as compared to control group. Serum ox-LDL and inflammatory biomarkers were positively correlated with the frequency of
Th17 cells and negatively correlated with the frequency of Treg cells. Treg and Th17 cells from ACI patients were significantly susceptible to ox-
LDL-mediated alterations in vitro. Conclusions: Th17/Treg cells were imbalanced in ACI patients, and ox-LDL may contribute to this imbalance
and lead to the occurrence of ACI suggesting their pathogenetic role in ACI. (IJCEP1304014).

Keywords: Cerebral infarction, transient ischemic attack, atherosclerosis, oxidized low-density lipoprotein, T helper 17, regulatory T cells

Address correspondence to: Dr. Shilian Hu, Department of Geriatrics, The Affiliated Provincial Hospital of Anhui Medical University, Hefei
230001, Anhui Province, PR China. Tel: +86 551 62283867; Fax: +86 551 62283875; E-mail: hushilian@yahoo.cn; Dr. Qing Li, The central
laboratory of Medical research center, The Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, Anhui Province, PR China.
Tel: +86 -551-62283574; Fax: +86 -551-62283574; E-mail: liqing-2001@163.com