Effects of immune modulation therapy on cardiac function in aged patients with chronic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effect of immune modulation therapy on cardiac function and lymphocyte subsets in aged patients with chronic heart failure (CHF).</p><p><b>METHODS</b>CHF (NYHA classification: II-IV) patients older than 60 years were randomly divided into two groups: CHF intervention group received regular therapy and thymopetide (2 mg/day i.m. for 75 days, n = 48), CHF control group received regular therapy (n = 48), 45 healthy individuals older than 60 years served as normal control. Left ventricular ejection faction of (LVEF), inner diameter of left ventricular end-diastole (LVEDD), inner diameter of left ventricular end-systole (LVESD), lymphocyte subsets, plasma high sensitive C-reactive protein (hsCRP), plasma brain natrium peptide (BNP) and 6 minutes walking distance (6MWT) were measured at before therapy, after the first course (15 days) of treatment and after the third course of treatment (75 days).</p><p><b>RESULTS</b>(1) Before therapy, the levels of BNP, hsCRP, CD8 T cells, LVEDD and LVESD were significantly higher and the levels of CD3, CD4, CD19 T cells, NK, CD4/CD8 ratio, LVEF and 6MWT were significantly lower in CHF patients compared to compared normal controls (all P < 0.05). These parameters were similar between CHF intervention group and CHF control group. (2) At 15 days, the levels of CD3, CD4, CD19 T cells and NK were significantly increased (P < 0.05 or P < 0.01) while the level of CD8, BNP and hsCRP were significantly decreased (P < 0.05 or P < 0.01) in CHF intervention group compared with CHF control group. (3) At 75 days, the levels of CD3, CD4, CD19 T cells, NK, CD4/CD8, LVEF and 6MWT were significantly increased (P < 0.05 or P < 0.01) while the levels of CD8, BNP, hsCRP and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were significantly decreased (P < 0.05 or P < 0.01) in CHF intervention group compared with CHF control group.</p><p><b>CONCLUSION</b>Thymopetide, an immune modulating agent, might regulate the quantity and proportion of lymphocyte subsets and improve cardiac function in aged patients with CHF, indicating that immune modulation therapy might be a new treatment strategy for aged CHF patients.</p>

Interaction of signal transduction between angiotensin AT1 and AT2 receptor subtypes in rat senescent heart / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiotensin II (Ang II) acting at angiotensin AT(1) receptor (AT(1)R) has well documented effects on cardiovascular structure such as the promotion of cardiovascular hypertrophy and fibrosis, which are believed to be opposed by angiotensin AT(2) receptor (AT(2)R) stimulation. The expressions of AT(1)R and AT(2)R are up-regulated in senescent hearts. The purpose of this study was to investigate the interaction of signal transduction between AT(1)R and AT(2)R, and to detect whether there is any difference in the interaction in rat hearts of different age.</p><p><b>METHODS</b>In 3.5-, 12-, 18- and 24-month-old rats, the heart cell membrane activities of protein kinase C (PKC) and tyrosine kinase were measured when AT(1)R and AT(2)R were both activated by Ang II or just the AT(1)R was activated by Ang II and PD123319. The activities of cytosolic phospholipase A(2) (cPLA(2)) and the levels of cGMP were investigated when AT(1)R and AT(2)R were both activated by Ang II or just the AT(2)R was activated by Ang II and losartan.</p><p><b>RESULTS</b>When AT(1)R and AT(2)R were both activated compared to when the AT(1)R was activated, the activities of PKC were not different in hearts from 3.5- and 12-month-old rats, but decreased significantly in 18- and 24-month-old rats; the activities of tyrosine kinase were not different in 3.5-month-old rats but decreased significantly in 12-, 18- and 24-month-old rats. The activities of cPLA(2) were all decreased significantly in rats of different age when AT(1)R and AT(2)R were both activated compared to when the AT(2)R was activated. Treatment with Ang II alone compared to Ang II and losartan decreased the levels of cGMP (fmol/mg) in rats of different age (102.7 +/- 12.7 versus 86.0 +/- 8.0 in 3.5-month-old rats, P < 0.05; 81.0 +/- 9.4 versus 70.0 +/- 6.3 in 12-month-old rats, P < 0.05; 69.8 +/- 5.6 versus 54.2 +/- 5.3 in 18-month-old rats, P < 0.01; 57.7 +/- 8.0 versus 39.0 +/- 3.0 in 24-month-old rats, P < 0.01).</p><p><b>CONCLUSIONS</b>The activation of AT(1)R inhibited the signal transduction of AT(2)R during the aging variation, and the activation of AT(2)R inhibited the signal transduction of AT(1)R in rat heart of different age.</p>