慢性乙型肝炎患者外周血单核细胞Toll样受体2和4的变化

Changes of Toll-like receptor （TLR） 2 and TLR4 on the peripheral blood mononuclear cells in patients with chronic hepatitis B and chronic severe hepatitis B

目的探讨慢性乙型肝炎和慢性重型乙型肝炎患者外周血单核细胞Toll样受体2 （TLR2）和Toll样受体4（TLR4）的变化情况及其意义。方法用流式细胞仪检测正常对照、慢性乙型肝炎患者和慢性重型乙型肝炎患者外周血单核细胞表面TLR2和TLR4的表达,ELISA法检测上述患者血清TNFα的水平。Student-t检验比较3组间TLR2、TLR4和TNFα表达的差异;3组病例TLR2、TLR4的表达水平间及它们与血清TNFα水平间的相关性分析采用线性相关分析。结果正常对照组（30例）、慢性乙型肝炎组（31例）和慢性重型乙型肝炎组（30例）外周血单核细胞TLR2和TLR4的平均免疫荧光强度（MFI）分别为21．5±2．7、39．0±4．1．47．7±21．4和2．3±1．1、3．7±2．3、6．9±4．1;外周血清TNFα（ng／L）水平分别为53．8±38．1、164．3±89．9、359．8±1 40．0,自正常对照组到慢性乙型肝炎组及慢性重型乙型肝炎组外周血单核细胞TLR2、TLR4表达强度和外周血清TNFα水平均依次显著升高;经线性相关分析研究发现,外周血单核细胞TLR2、TLR4表达水平和血清TNFα表达水平间均呈现显著的正相关性。结论TLR2和TLR4可能与慢性乙型肝炎及慢性重型乙型肝炎的发病有关。

Objective To study the changes of TLR2 and TLR4 on peripheral blood mononuclear cells （PBMCs） and their role in the pathogenesis of chronic hepatitis B and chronic severe hepatitis B. Methods The expressions of TLR2 and TLR4 on 10000 CD 14^＋ PBMCs were determined by flow cytometry in 30 healthy controls, in 31 patients with chronic hepatitis B and in 30 patients with chronic severe hepatitis B. The level of serum tumor necrosis factor α （TNF α） was determined by ELISA. The differences of expression of TLR2 and TLR4 on PBMCs and serum TNF α among the three groups of study subjects were determined by Student-t test. The correlations between TLR2, TLR4 and TNF α were determined by linear correlation test. Results The values of mean fluorescence intensity （MFI） of TLR2 on PBMCs of the healthy controls, patients with chronic hepatitis B and patients with chronic severe hepatitis B groups were 21.5±2.7, 39.0±4.1, and 47.7±21.4; TLR4 of those groups was 2.3±1.1, 3.7±2.3, and 6.9±4.1. The serum TNF α （ng/L） of the respective groups was 53.8±38.1, 164.3±89.9, and 359.8±140.0. There was a gradual increase of these values from the group of healthy controls to the group of patients with chronic hepatitis B and patients with chronic severe hepatitis B. No significant positive correlations between TLR2, TLR4 and serum TNF α were found. Conclusion TLR2 and TLR4 may have a role in the pathogenesis of chronic hepatitis B and chronic severe hepatitis B.