慢性阻塞性肺疾病患者外周血单个核细胞TREM-1mRNA的表达

Expression of TREM-1 mRNA in peripheral blood monocytes of patients with chronic obstructive pulmonary disease

目的探讨外周血单个核细胞内髓样细胞触发受体-1(TREM-1)mRNA表达在慢性阻塞性肺疾病(COPD)发病机制中的作用及与气道炎症的关系。方法随机选取2015年9月至2016年3月川北医学院附属医院呼吸内科门诊及住院COPD患者共60例,治疗前为COPD急性加重期(AECOPD期),经治疗后病情稳定为COPD稳定期(SCOPD期)。根据其肺功能(FEV1/FVC和FEV1占预计值%)、症状、改良呼吸困难指数(m MRC)以及过去1年急性加重次数进行综合评估,将SCOPD期分为低风险组和高风险组,每组30例。选取同期健康体检者30例为正常对照组。采用实时荧光定量逆转录聚合酶链反应(RT-PCR)法和酶联免疫吸附法(ELISA)分别检测各组对象外周血单个核细胞内TREM-1 mRNA的表达量及血浆可溶性TREM-1(s TREM-1)、白细胞介素(IL)-1β的含量。结果TREM-1 mRNA的相对表达量及s TREM-1、IL-1β含量,在AECOPD期患者均明显高于SCOPD期患者(P均<0.01);且在两期患者均明显高于对照组(P均<0.01);在SCOPD高危组患者均高于低危组患者(P均<0.05),且在两组患者均高于正常对照组(P均<0.05)。COPD患者TREM-1 mRNA的相对表达量与血浆IL-1β、s TREM-1含量呈正相关(r=0.82,P<0.01;r=0.78,P<0.01),血浆IL-1β与s TREM-1含量也呈正相关(r=0.81,P<0.01)。结论 TREM-1、s TREM-1和IL-1β可能参与了COPD的气道炎症反应,且与COPD患者的病情严重程度存在正相关关系。

Objective To investigate the effect of triggering receptor exprssed on myeloid cells-1（ TREM-1） mRNA in peripheral blood monocytes（ PBMCs） on pathogenesis of chronic obstructive pulmonary disease（ COPD） and its association with airway inflammation. Methods Sixty outpatients and inpatients with COPD in Respiratory Department of Affiliated Hospital of North Sichuan Medical College from September 2015 to March 2016 were selected. The patients were all in acute exacerbation（ AECOPD） stage before treatment and entered the stable period（ SCOPD stage）. After comprehensive evaluation on the basis of lung functions [FEV1/ FVC,ratio（ %） of FEV1 to its predicted value-FEV1（ %） ],symptoms,modified Medical Research Council dyspnea scale（ m MRC） and acute exacerbation frequency in past one year,the patients in SCOPD stage were divided into two groups（ n = 30 each） ： low-risk group and high-risk group. Thirty healthy subjects at the same period were served as normal control group. Real-time fluorescent quantitative reverse transcription-polymerase chain reaction（ RT-PCR） and enzyme linked immunosorbent assay（ ELISA） were used to respectively detect the expression level of TREM-1 mRNA in PBMCs and the contents of plasma soluble TREM-1（ s TREM-1） and interleukin（ IL）-1β. Results The relative expression levels of TREM-1 mRNA and the contents of plasma s TREM-1 and IL-1β were all significantly higher in AECOPD stage patients than those in SCOPD stage patients（ all P〈0. 01）,and also higher in both AECOPD stage and SCOPD stage patients than those in normal control group（ all P〈0. 01）. In SCOPD stage patients,the relative expression levels of TREM-1 mRNA and the contents of plasma s TREM-1 and IL-1β were all significantly higher in high-risk group than those in low-risk group,as well as higher in both low-risk group and high-risk group than those in normal control group（ all P〈0. 05）. In COPD patients,the relative expression levels of TREM-1 mRNA was positively correlated with the contents of plasma s TREM-1 and IL-1β（ r = 0. 82,P〈0. 01; r = 0. 78,P〈0. 01）,and the content of serum IL-1β was also positively correlated with the content of plasma s TREM-1（ r = 0. 81,P〈0. 01）. Conclusion TREM-1,s TREM-1 and IL-1β may be involved in airway inflammatory response of COPD,and they are positively correlated with the severity of COPD.