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月刊
主管单位:
上海市卫生健康委员会
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CN31-1366/R
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阿托伐他汀对慢性心衰患者外周血TLR4表达的影响
Effects of Atorvastatin on TLR4 Expression on Circulating Monocytes in Patients with Chronic Heart Failure

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DOI:
作者:
吴炎
吴炎、蒲红
作者单位:
解放军85医院心血管内科
the 85 Hospital of the People's Liberation Army
关键词:
慢性心衰，TLR，阿伐他汀，免疫
Chronic heart failure; Toll—like receptor4; statin; immune
摘要:
目的：探讨慢性充血性心力衰竭（CHF）患者外周血单个核细胞Toll样受体4（TLR4）表达改变情况及其阿托伐他汀的干预效应。方法：选取住院的慢性充血性心力衰竭患者80例，其中40例为标准药物治疗组，另外40名在标准治疗基础上给与阿托伐他汀20mg/日，治疗前和治疗一月后用流式细胞仪检测外周血单核细胞表面TLR4的表达，ELISA法检测血清TNFα水平；并对TLR4的表达与血清TNFα水平进行相关性分析。结果：CHF患者外周循环单个核细胞TLR4表达水平较对照组明显增高（p<0.05），并且与血清TNFα水平呈正相关；与标准治疗比，标准治疗基础上给与阿托伐他汀20mg/日治疗一个月，可在明显降低外周血单核细胞TLR4的表达和血清TNFα水平。结论：TLR4表达可能与CHF发生有关，阿托伐他汀可显著降低外周血单核细胞TLR4的表达，推测阿托伐他汀的抗炎症免疫作用与抑制TLR4介导的炎症免疫反应有关。
Objective：To study the changes of Toll—like receptor4 (TLR4) on peripheral blood mononuclear cells(PBMCs) and their role in the pathogenesis of chronic heart failure(CHF). Methods Eighty CHF patients were recruited．40 patients were randomized to routine anti-heart failure treatment group or atorvastatin group(20 mg/d) on top of routine anti-heart failure treatment for one month．40 age-matched healthy subjects were regarded as normal control. TLR4 expression on monocytes were measuered via flow-cytometry before and after one month treatment．Serum level of TNFα were meathored by ELIZA. Results Before treatment, TLR4 expression on monocytes were higher in routine anti-heart failure treatment group and atorvastatin treatment group than normal controls. ( 3.8±1.9 vs.3.7士2.1 vs 1.8±0.5. P<0.05). After one month treatment with atorvastatin, TLR4 expression were significantly decreased compared with routine anti-heart failure treatment group.( 3.4±1.1 vs. 2.2±1.8) . Serum TNFα level correlated with TLR4 expression level (r=0.076, P<0.05). Conclusion CHF is associated with enhanced expression of TLR4 in circulating monocytes. Treatment with atorvastatin with short time could significantly decreased TLR4 expression. The anti-inflammatory effect by atorvastatin may be partially dued to down-regulating the expression of TLR4.

 

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