人急性胰腺炎早期外周血单核细胞Toll样受体4及CD14表达变化

Changes of toll like receptor 4 and CD14 expression on peripheral blood monocytes during early stage of human acute pancreatitis

目的探讨人急性胰腺炎早期外周血单核细胞(peripheral blood monocytes,PBMCs)表面Toll样受体4(toll like receptor 4,TLR4)、CD14表达变化。方法收集发病24 h内入院的早期急性胰腺炎病人36例,采集入院当日及第3、第7日外周血,分离单核细胞。用流式细胞术检测单核细胞表面TLR4、CD14表达变化情况。同时检测血清肿瘤坏死因子(tumor necrosis factor alpha, TNF-α)、白细胞介素6(interlelakin 6,IL-6),研究它们之间的相关性。结果急性胰腺炎病人外周血单核细胞表面TLR4发病后表达上调,在轻症病人渐下降,1周左右恢复正常。TNF-α的变化一致。结论人急性胰腺炎早期可能通过先天性免疫门户蛋白TLR4激活单核巨噬细胞系统导致TNF-α等促炎细胞因子的产生和释放。

Objective To study toll like receptor 4 （TLR4） expression on peripheral blood monocytes （PBMCs during the early stage of human acute pancreatitis （AP）, Methods Thirty-six consecutive patients with AP admitted to our hospital within 24 h of onset of abdominal pain were enrolled prospectively in this study, Blood samples were collected by venipuncture at admission and on the 3rd and 7th d after admission to isolate PBMCs. TLR4 and CD14 expression on PBMCs was determined by flow cytornetry. Serum levels of TNF-α and IL-6 were simultaneously measured. The correlation among these parameters was analyzed. Results In mild AP, TLR4 expression level increased on the 1st d after admission and then continued to decline for several days. On the 7th d, TLR4 expression was almost normal. The changes of serum TNF-α were coincident with those of TLR4. Conclusions Mononuclear macrophages might be activated by TLR4 to result in production and release of TNF-α.