急性轮状病毒腹泻小儿单个核细胞Toll样受体的变化

Expression of Ton-nke receptors in mononuclear cells from children with acute rotavirus diarrhea

目的 研究轮状病毒腹泻小儿单个核细胞Toll样受体的变化。方法 收集3岁以下因急性轮状病毒腹泻来复旦大学附属儿科医院就诊的小儿75例，以荧光定量RT-PCR方法检测外周血单个核细胞TLR2，3、4、7、8 mRNA的表达情况。结果 起病时间在3d以内的小儿外周血单个核细胞中TLR 2、3、4、7、8 mRNA的表达水平都有明显升高，P均〈0．05。其中TLR 2．3、8 mRNA表达在发病7d和14d时仍高于对照组，P均〈0．05。TLR 4 mRNA的表达在病情较重的息儿比较轻的患儿高，P〈0．05。结论 多种TLR参与了轮状病毒引发的宿主免疫应答反应的启动和调节。

Objective Rotavirus is the single most common cause of severe dehydrating diarrhea in young children worldwide, but the pathogenesis and immunity against this disease are not completely understood. A prospective study was conducted to assess gene expression of toll-like receptors （TLR） in children with acute rotavirus diarrhea. Methods Seventy-five children with acute rotavirus diarrhea and 38 control children were enrolled in this study from Sep. 2004 to Jan. 2005. All the 75 patients had detailed records of clinical characteristics. Rotavirus antigen was detected by ELISA from stools. Peripheral blood mononuclear cells （PBMC） were separated hy Ficoll reagent and RNA was extracted hy Trizol. The levels of mRNA for five TLRs in PBMC were examined by fluorescent quantitative RT-PCR. Results Patients with acute rotavirus infection had elevated mean levels of TLR 2,3,4,7,8 mRNA expressions in PBMC within 3 days since onset of the disease, P 〈 0.05. But only TLR 2,3,8 mRNA levels remained increased in patients within 7 or 14 days since onset （ P 〈 0.05）. Mean levels of mRNA for TLR 4 in PBMC was higher in patients with more severe diarrhea including longer duration of diarrhea, more episodes of diarrhea per day and higher severity scores （ P 〈 0.05 ）. Conclusions Manifold TLR may play roles in the start-up and regulation of immune responses in children with acute rotavirus diarrhea. These findings will be helpful to further recognize immune response in Chinese children with retavirus diarrhea and, consequently, may provide directions and insights that could prove critical to the prevention or treatment of this important disease.