慢性肾炎患者外周血淋巴细胞Toll样受体4的表达及意义

Clinical significance and expression of TLR4 on the lymphocyte in peripheral blood in patients with chronic nephritis

目的探讨TLR4在慢性肾炎患者外周血淋巴细胞中的表达及意义。方法用流式细胞术检测22例慢性肾炎患者和30例正常人群外周血B淋巴细胞(CD19+)、T淋巴细胞(CD3+)表面TLR4的表达。结果①慢性肾炎患者CD19+TLR4+细胞百分率([35.01±25.70)%]显著高于正常对照([16.42±5.65)%(]t=3.850,P<0.01),而CD3+TLR4+细胞百分率([34.81±24.91)%]与正常对照组([27.22±16.71)%]比较,差异无显著性(t=1.315,P=0.194);②慢性肾炎患者外周血CD19+TLR4+细胞百分率与尿微量白蛋白排泄率(UAE)(P=0.000374,r=0.703)、尿微量总蛋白浓度(M-TP)呈正相关(P=0.00374,r=0.783),与血白蛋白(ALB)呈负相关(P=0.0285,r=-0.564)。结论B细胞表面TLR4可能在肾脏炎症性疾病的发生中具有重要作用,有望作为肾小球滤过功能损伤严重程度的指标之一。

[ Objectives ] To study the chnical significance and expression of Toll-like receptor 4 （TLR4） on the lymphocyte in peripheral blood in patients with chronic nephritis. [Methods] Expression of TLR4 on the B lymphocyte（CD19^＋） and the T lymphocyte（CD3^＋） in peripheral blood were measured in 30 normal control and 22 patients with chronic nephritis by Flow cytometry analysis. [Result] Compared with normal controls [（16.42±5.65）%], the TLR4 positive expression rate on the B lymphocyte were significantly higher in patients with chronic nephritis [（35.01± 25.70）%]（t =3.850,P 〈0.01）;but there were no significant differences between the TLR4 positive expression rate on the T lymphocyte in patients with chronic nephritis [（34.81±24.91）%] and in normal control [（27.22±16.71）%]（t = 1.315, P =0.194）. The CD19^＋TLR4^＋ rate in patients with chronic nephritis were positive correlated with the UAE （P = 0.000374, r =0.703）, M-TP （P =0.00374, r =0.783）, and the CD19^＋TLR4^＋ rate in patients with chronic nephritis were negative correlation with ALB（P =0.0285, r =-0.564）. [ Conclusions] TLR4 on the B lymphocyte play an important role in the pathogenesis of chronic nephritis,and could be one of the indexes which hinted the severity of the damage in glomerular filtration.