不同性别冠心病患者TLR2和TLR4的表达及其与性激素的关系

The relationship between TLR2/TLR4and sex hormone in the patients of coronary heart disease in different gender

目的:探讨冠心病患者Toll样受体(TLR)2和4的表达与性别及雌二醇、睾酮之间的关系。方法:根据冠状动脉造影结果将研究人群分为冠心病组(122例,男70例,女52例)和正常对照组(55例,男29例,女26例),各组再根据性别分为男、女亚组,应用实时荧光定量RT-PCR法检测外周动脉血单个核细胞TLR2和TLR4mRNA的表达;化学发光法测定血浆E2及T的水平。结果:冠心病组男性及女性外周血单个核细胞TLR2和TLR4mRNA的表达均分别高于对照组的男性和女性[男性:TLR2mRNA:(0.006 0±0.001 8)︰(0.005 2±0.001 8);TLR4mRNA:(0.006 9±0.002 1)︰(0.005 3±0.001 5);均P<0.05。女性:TLR2mRNA:(0.005 4±0.001 9)︰(0.004 5±0.001 8),TLR4mRNA:(0.005 7±0.001 7)︰(0.004 8±0.001 9);均P<0.05]。冠心病组男性患者睾酮水平低于对照组男性[(5.45±1.75)ng·ml-1︰(6.65±1.93)ng·ml-1;P<0.05],冠心病组女性患者血浆雌二醇水平低于对照组女性[(27.27±5.88)pg·ml-1︰(30.21±6.36)pg·ml-1;P<0.05]。冠心病男性患者TLR2和TLR4mRNA均与血浆睾酮水平呈负相关(r值分别为-0.412和-0.583,均P<0.05),冠心病女性患者TLR2和TLR4mRNA均与血浆雌二醇水平呈负相关(r值分别为-0.446和-0.662,均P<0.05)。结论:老年男性睾酮水平降低及绝经后女性雌激素降低是冠心病发病的重要危险因素,其机制可能与TLR2及TLR4表达升高有关。

Objective：To examine whether the expressions of Toll like receptor 2and 4mRNA in peripheral blood mononuclear cells（PBMCs）are associated with serum levels of testosterone（T）and estradiol（E2）in the patients of coronary heart disease（CHD）in different gender.Method：According to the coronary angiography,a total of 70 aging men and 52 postmenopausal women with CHD were enrolled in CHD group,meanwile,29 male and26female with normal coronary arteries were enrolled as control group,respectively.The expressions of TLR2 and 4mRNA were detected by Real-time fluorescence quantitation polymerase chain reaction（RT-PCR）.The concentrations of plasma E2 and T were measured by Chemiluminescence.Result：Compared to control group,the expressions of TLR2 mRNA and TLR4 mRNA were higher either in male or female patients in CHD group,respectively[male：TLR2mRNA：（0.006 0±0.001 8）︰（0.005 2±0.001 8）;TLR4mRNA：（0.006 9±0.002 1）︰（0.005 3±0.001 5）;both P〈0.05.Female：TLR2mRNA：（0.005 4±0.001 9）︰（0.004 5±0.001 8）,TLR4mRNA：（0.005 7±0.001 7）︰（0.004 8±0.001 9）;both P〈0.05].The level of E2 in female patients with CHD was lower than that in control[（27.27±5.88）pg·ml^-1 vs（30.21±6.36）pg·ml^-1,P〈0.05）while the level of T in male patients with CHD was lower than in control[（5.45±1.75）ng·ml^-1 vs（6.65±1.93）ng·ml^-1,P〈0.05].The expression of TLR2 and TLR4mRNA on peripheral blood mononuclear cells was negatively related to the plasma level of T in male patients with CHD（r=-0.412and-0.583,respectively,both P〈0.05）,and was negatively related to the level of E2 in female patients with CHD（r=-0.446and-0.662,respectively,both P〈0.05）.Conclusion：Lower T levels in old man and lower estrogen levels in postmenopausal women are important risk factors of CHD,and the upregulation of TLR2 and TLR4may be at least one of the underlying mechanisms.