全身炎症反应综合征患者外周血单个核细胞Toll样受体2、4基因表达及其意义

Expression and significance of toll-like receptor 2, 4 in peripheral blood mononuclear cells in patients with systemic inflammatory response syndrome

目的探讨急腹症全身炎症反应综合征(SIRS)患者外周血单个核细胞(PBMC)内Toll样受体(TLR)2、4基因表达变化及其意义。方法103例急腹症手术患者包括SIRS组65例,非SIRS组38例。采用逆转录聚合酶链反应(RT PCR)法检测TLR2、4mRNA的变化;酶联免疫吸附试验(ELISA)法检测TNF α和IL 6的表达;分析TLR2、4mRNA与TNF α和IL 6的表达量、住院时间和多器官功能障碍综合征(MODS)发生率之间的关系。结果入院第1天TLR4mRNA、TNF α和IL 6表达均升高至峰值,随后随病程下降,TLR2mRNA自入院起持续高表达至第5天,TLR2、4mRNA的表达与TNF α和IL 6、住院时间呈正相关,且TLR2、4mRNA表达越高,发生MODS的危险性越大。结论急腹症SIRS患者PBMC内TLR2、4基因表达显著增加,提示TLR在急腹症SIRS的发生发展过程中发挥了重要的促进作用。

Objective To explore changes of toll like receptor(TLR) 2, 4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome(SIRS) and their significance. MethodsA clinical study was done on 103 patients in which 65 were with SIRS. The mRNA expression of TLR2, 4 were detected by RT PCR; the expression of TNF α and IL 6 were observed by ELISA; the correlation between TLR2, 4 mRNA, the level of TNF α and IL 6,and the clinical course was evaluated. ResultsTLR2 mRNA, TNF α and IL 6 were upregulated markedly on the first day of hospitalization, then decreased gradually; TLR2mRNA maintained on high level till the 5th day. The expression of TLR2, 4 mRNA was positive correlated with the level of TNF α and IL 6, and the length of stay. TLR2, 4 mRNA expression increased in patients with multiple organ failure. ConclusionsIn acute abdomen patients with SIRS, the expression of TLR2, 4 of PBMC increased markedly, indicating its important role in the pathogenesis of SIRS.