Circulating level of regulatory T cells in rheumatic heart disease: An observational study

Indian Heart J. 2016 May-Jun;68(3):342-8. doi: 10.1016/j.ihj.2015.08.009. Epub 2016 Jan 19.

Abstract

Background: The regulatory T cell (Treg) is essential for prevention of autoimmunity. In a preliminary study, we showed significant deficiency of Tregs (CD4CD25 T cells) in rheumatic heart disease (RHD) patients (an autoimmune disease), but the markers used could not reliably differentiate Treg from nonregulatory conventional T cells (Tcon). The study aim was to reassess the level of circulatory Tregs by using more specific markers.

Methods: 70 adults of RHD and 35 controls were studied. Patients were subdivided according to the extent of left-sided valvular involvement. 35 patients with significant mitral-valve disease only were enrolled in the univalvular group while 35 patents with significant involvement of both mitral and aortic-valves in the multivalvular group. Circulating Treg cell level was determined by flow-cytometry.

Results: Level of Tregs (CD4+CD25(med-high)CD127(low) Foxp3(high)) in CD4+ T lymphocyte was significantly lower in RHD patients compared to controls (median 0.6% versus 3.2%; p=0.001) with no significant difference in Tcon cells (p=0.94). Within the study group Treg count was significantly lower in patients with multivalvular-disease only (median 0.1% versus 3.2%; p=0.001) with no significant difference in Treg cell count between the univalvular group and control (median 1.9% versus 3.2%, p=0.10).

Conclusion: There is significant deficiency of circulating Tregs in patients of chronic RHD and the deficiency is greater in patients with multivalvular than univalvular involvement.

Keywords: Conventional T cell; Regulatory T cell; Rheumatic heart disease.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Autoimmunity*
  • Cross-Sectional Studies
  • Echocardiography
  • Female
  • Flow Cytometry
  • Humans
  • Lymphocyte Count
  • Male
  • Rheumatic Heart Disease / blood
  • Rheumatic Heart Disease / diagnosis
  • Rheumatic Heart Disease / immunology*
  • T-Lymphocytes, Regulatory / immunology
  • T-Lymphocytes, Regulatory / pathology*