TLRs/MyD88信号通路在膝骨性关节炎患者滑膜炎症中的作用

Role of TLRs MyD88 signaling pathway in synovitis inflammation in patients with knee osteoarthritis

目的探讨Toll样受体/人髓样分化因子88(TLRs/MyD88)信号通路在膝骨性关节炎患者滑膜炎症中的作用。方法2017年1月-2019年1月,回顾性收集广东省佛山市中医院收治的膝骨性关节炎患者120例,同时收集健康志愿者50例作为对照组,观察2组患者膝关节液中TLRs/MyD88信号通路相关炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)和基质金属蛋白酶-13(MMP-13)],同时检测观察组滑膜中TLRs/MyD88信号通路中相关指标(TLR2、TLR4、MyD88),分析TLRs/MyD88信号通路相关指标与膝骨性关节炎病情严重度的相关性。结果与对照组比较,观察组关节液中TNF-α、IL-1和MMP-13表达增加,差异均有统计学意义(P<0.05)。滑膜细胞中TLR2阳性细胞比为(53.93±12.73)%,TLR4阳性细胞比为(59.73±14.74)%,MyD88阳性细胞比为(63.85±15.96)%。Pearson线性相关性分析显示滑膜厚度、髌上囊液体深度、髌下囊液体深度、关节腔液体深度与TLR2、TLR4、MyD88、TNF-α、IL-1、MMP-13均显著正相关(P<0.05)。膝骨性关节炎患者Lysholm膝关节评分与TLR2、TLR4、MyD88、TNF-α、IL-1、MMP-13均显著负相关(P<0.05)。结论TLRs/MyD88信号通路可能在膝骨性关节炎患者中被激活,加速膝关节退变的发展过程。

Objective To investigate the role of TLRs/MyD88 signaling pathway in synovitic inflammation in patients with knee osteoarthritis.Methods From January 2017 to January 2019,120 patients with knee osteoarthritis admitted to our hospital were retrospectively collected as an observation group,and 50 healthy volunteers were collected as a control group.Inflammatory markers related to TLRs/MyD88 signaling pathway in knee joint fluid of the two groups(TNF-α,IL-1 and MMP-13),and TLRs/MyD88 signal pathway related indexes(TLR2,TLR4,MyD88)were detected in the synovium of the observation group.The correlation between TLRs/MyD88 signaling pathway and the severity of knee osteoarthritis were analyzed.Results Compared with the control group,the expression of TNF-α,IL-1 and MMP-13 were increased in the synovial fluid of the observation group.In the observation group,the ratio of TLR2 positive cells,TLR4 positive cells and MyD88 positive cells were(53.93±12.73)%,(59.73±14.74)%,(63.85±15.96)%respectively.Pearson linear correlation analysis showed that synovial thickness,suprapatellar capsule fluid depth,subpatellar capsule fluid depth,joint cavity fluid depth were positively correlated with TLR2,TLR4,MyD88,TNF-α,IL-1 and MMP-13(P<0.05),while Lysholm score was negatively correlated with TLR2,TLR4,MyD88,TNF-α,IL-1 and MMP-13(P<0.05).Conclusion TLRs/MyD88 signaling pathway may be activated in patients with knee osteoarthritis and accelerates the development of knee degeneration.