糖皮质激素对嗜酸性胃肠炎患儿外周血单核细胞TLR4水平的影响

Influence of glucocorticoids on TLR4 level in peripheral blood mononuclear cells of children with eosinophilic gastroenteritis

目的探讨糖皮质激素对嗜酸性胃肠炎(EG)患儿外周血单核细胞TOLL样受体4 (TLR4)影响以及与嗜酸性粒细胞(EOS)数量的相关性,为寻找理想的诊断、治疗EG的检测指标提供参考。方法将58例EG患儿随机分为A组和B组各29例,另选取正常儿童30例作为对照组,A组患儿仅给予安慰剂治疗,B组患儿每日给予10 mg强的松治疗,根据患儿症状减轻而减少药物用量,治疗时间为2周。对比患儿治疗前、后外周血WBC与EOS含量变化,采用即逆转录-聚合酶链反应法(RT-PCR)和流式细胞仪检测患儿治疗前、后外周血单核细胞TLR4水平,并对外周血单核细胞TLR4水平与外周血WBC、EOS水平间关系进行Pearson相关性分析。结果治疗前与对照组儿童相比,A、B两组患儿外周血中WBC计数、EOS百分比均升高,差异有统学意义(P<0. 05)。治疗后B组患儿WBC、EOS百分比、EOS数量均低于治疗前,且低于A组患儿,差异有统计学意义(P<0. 05)。治疗前后A组患儿外周血单核细胞TLR4 mRNA表达及平均荧光强度差异无统计学意义(P>0. 05); B组患儿治疗后TLR4 mRNA表达及平均荧光强度低于治疗前,差异有统计学意义(P<0. 05)。外周单核细胞中TLR4水平与治疗前患儿外周血EOS水平呈显著性正相关(P<0. 05)。结论嗜酸性胃肠炎患儿采用糖皮质激素之后能够抑制外周血单核细胞TLR4水平,而后者可能与外周血EOS存在一定的联系,共同参与糖皮质激素治疗。

Objective To explore the influence of glucocorticoids on Toll-like receptor-4( TLR4) level in peripheral blood mononuclear cells of children with eosinophilic gastroenteritis( EG),and the correlation with the number of eosinophils( EOS),in order to provide reference for finding the ideal diagnostic and therapeutic indexes of EG. Methods 58 children with EG were randomly divided into group A and group B,29 cases in each group. 30 cases of normal children were selected as normal group. Group A was just given placebo,and group B was given 10 mg prednisone daily,reducing the amount according to children's symptoms,treatment lasted for 2 weeks. The amount of WBC and EOS in peripheral blood were contrasted before and after treatment,and TLR4 levels was detected by reverse transcription polymerase chain reaction( RT-PCR) and flow cytometry,the correlation between TLR4 level and WBC/EOS level in peripheral blood was analyzed by Pearson correlation analysis. Results Compared with those of normal group,the percentages of WBC and EOS in peripheral blood of group A and group B were increased before treatment,the differences were statistically significant( P<0. 05). After treatment,the number of WBC,EOS were decreased in group B than before treatment and those of group A,the differences were statistically significant( P<0. 05). There were no significant differences in TLR4 mRNA expression and average fluorescence intensity of group A between before and after treatment( P> 0. 05),and the levels of TLR4 mRNA in group B were decreased after treatment than those of before treatment.There was a significant positive correlation between TLR4 level in peripheral mononuclear cells and EOS level before treatment( P< 0. 05).Conclusion Glucocorticoids could inhibit TLR4 level of EG patients,and which might be related to peripheral blood EOS,and co-participate in treatment of glucocorticoid.