肝硬化患者外周血单核细胞表面TLR4和TLR2表达的临床意义

Clinical signif icance of Toll-like receptor 4 and 2 expression on the surface of peripheral blood mononuclear cells in patients with liver cirrhosis

目的:探讨肝硬化患者外周血中单个核细胞(PBMC)表面Toll样受体4(Toll-likereceptor4,TLR4)、TLR2表达与肝硬化患者细菌感染的关系,观察抗生素治疗对TLR4与TLR2表达的影响.方法:采用三色荧光染色法,荧光素标记的抗TLR2/抗TLR4/抗CD14mAb对42例肝硬化患者及正常人的血液单核细胞表面TLR2、TLR4及CD14分子进行免疫荧光染色,应用流式细胞仪检测.结果:肝硬化腹水组TLR2和TLR4表达(n=30,TLR2,47.65±0.75;TLR4,22.28±0.80)与正常对照组(n=15,TLR2,24.40±2.77;TLR4,14.45±3.23)比较有显著性差异(P<0.05),肝硬化腹水患者治疗前(n=20,TLR2,47.79±0.76;TLR4,28.58±0.79)和治疗后(n=20,TLR2,17.22±2.48;TLR4,12.37±0.35)比较有显著性差异(P<0.05);肝硬化腹水患者与肝硬化无腹水患者组(n=12,TLR2,25.37±1.62;TLR4,14.81±0.29)比较有显著性差异(P<0.05);肝硬化无腹水患者组与正常对照组比较无显著性差异(P>0.05).结论:肝硬化腹水患者TLR4与TLR2的表达显著上调,抗生素治疗后显著下调.

AIM： To explore the correlation of Toll-like receptor 4, Toll-like receptors 2 expression on the surface of peripheral blood mononuclear cells with bacterial infection in patients with liver cirrhosis, and observe the effect of antibiotics on PBMC expression of TLR4 and TLR2 in cirrhosis. METHODS： Blood cells from a total of 42 patients （30 with ascites, 12 without ascites） with liver cirrhosis and 15 normal controls were stained with fluorescent labeling anti-TLR2/ anti-TLR4/anti-CD14 monoclonal antibodies. Samples were collected and analyzed for threecolor immunofluorescence by flow cytometry.RESULTS： The expression of TLR4 and TLR2 were significantly higher in patients with ascites than those in the controls （TLR4：22.28±0.80 vs 14.45 ± 3.23, P 〈 0.05; TLR2：47.65 ± 0.75 vs 24.40 ± 2.77, P 〈 0.05）, and marked difference also existed before and after treatment （TLR4：28.58 ± 0.79 vs 12.37 ± 0.35, P 〈 0.05; TLR2：47.79 ± 0.76 vs 17.22 ± 2.48, P 〈 0.05）. TLR4 and TLR2 expression were notably increased in patients with ascites as compared with those in ones without ascites （TLR2：25.37 ± 1.62; TLR4：14.81 ±0.29） （P 〈 0.05）, and they were not significantly different between patients without ascites and normal controls （P 〉 0.05）. CONCLUSION： PBMC expression of TLR4 and TLR2 are up-regulated in patients with liver cirrhosis, and they can be down-regulated by anti- biotics treatment.