■低分子质量蛋白7(LMP7)加重T细胞异常分化和动脉粥样硬化,但其在急性缺血性卒中(AIS)中的临床作用尚不清楚。本研究旨在探讨外周血单个核细胞(PBMC)LMP7与T细胞亚群的相关性,疾病严重程度,AIS患者的预后。
■共有162例AIS患者通过逆转录聚合酶链反应和流式细胞术检测PBMCLMP7和T辅助(Th)1,Th2和Th17细胞,分别。此外,还定量了出院时的PBMCLMP7。
■入院时LMP7增加与Th2细胞减少相关(P=0.014),Th17细胞升高(P<0.001),C反应蛋白(P=0.005),美国国立卫生研究院卒中量表(NIHSS)评分(P=0.007),和疾病严重程度(由NIHSS评分定义)(P=0.010)。入院时的LMP7反映了卒中复发的高风险(曲线下面积(AUC):0.748,95%置信区间(CI):0.564-0.932),但在第3个月(M3)>2(AUC:0.585,95CI:0.479-0.691)时,或死亡(AUC:0.723,95CI:0.338-1.000)。出院时LMP7较入院时降低(P<0.001)。出院时LMP7与卒中复发风险(AUC:0.849,95CI:0.735-0.963)和死亡风险(AUC:0.919,95CI:0.836-1.000)呈正相关,但在M3>2时反映mRS评分的能力较弱(AUC:0.671,95CI:0.578-0.765)。
■PBMCLMP7与Th17细胞呈正相关,炎症,和AIS患者的疾病严重程度,同时,出院时的水平显示出很好的反映卒中复发和死亡风险的能力。
Low molecular mass protein 7 (LMP7) aggravates abnormal T cell differentiation and atherosclerosis, but its clinical role in acute ischemic stroke (AIS) is still unclear. This study aimed to investigate the correlation of peripheral blood mononuclear cell (PBMC) LMP7 with T cell subsets, disease severity, and prognosis in AIS patients.
A total of 162 AIS patients were enrolled for detecting PBMC LMP7 and T helper (Th) 1, Th2, and Th17 cells via reverse transcriptase-polymerase chain reaction and flow cytometry, respectively. In addition, PBMC LMP7 at discharge was also quantified.
Increased LMP7 at admission was associated with decreased Th2 cells (P=0.014), elevated Th17 cells (P<0.001), C-reactive protein (P=0.005), National Institutes of Health Stroke Scale (NIHSS) score (P=0.007), and disease severity (defined by NIHSS score) (P=0.010). LMP7 at admission reflected a high risk of stroke recurrence (area under curve (AUC): 0.748, 95% confidence interval (CI): 0.564-0.932), but not mRS score at month 3 (M3) >2 (AUC: 0.585, 95%CI: 0.479-0.691), or death (AUC: 0.723, 95%CI: 0.338-1.000). LMP7 at discharge was reduced compared to that at admission (P<0.001). LMP7 at discharge was positively correlated with the risk of stroke recurrence (AUC: 0.849, 95%CI: 0.735-0.963) and death (AUC: 0.919, 95%CI: 0.836-1.000), but had a weak capacity to reflect mRS score at M3 >2 (AUC: 0.671, 95%CI: 0.578-0.765).
PBMC LMP7 positively correlates with Th17 cells, inflammation, and disease severity in AIS patients, meanwhile, its level at discharge shows a good ability to reflect the risks of stroke recurrence and death.