过敏性紫癜患儿外周血Toll样受体2与血浆细胞因子的相关性

Correlation between Toll like receptor 2 and plasma cytokines in children with henoch schonlein purpura

目的:分析过敏性紫癜(HSP)合并肾损害患儿外周血单核细胞Toll样受体2(TLR2)表达水平及其与血浆细胞因子γ-干扰素(INF-γ)、白细胞介素4(IL-4)的相关性。方法:采用回顾性研究,收集78例HSP患儿的临床资料,依据是否伴有肾损害,分为肾损害组(35例)与无肾损害组(43例)。选取同期健康体检儿童40例为对照组。比较受测者入院时血浆INF-γ、IL-4的含量,以及外周血单核细胞TLR2 mRNA和蛋白的水平。采用Pearson分析HSP合并肾损害患儿外周血单核细胞TLR2蛋白与血浆INF-γ/IL-4比值的相关性。结果:与对照组比较,HSP组血浆INF-γ、INF-γ/IL-4比值均明显降低,IL-4含量明显升高(P<0.05)。与对照组比较,THSP组TLR2 mRNA和蛋白的水平均明显上升(P<0.05)。与无肾损害组比较,肾损害组的HSP患儿TLR2 mRNA和蛋白的水平均明显上升(P<0.05)。HSP合并肾损害患儿TLR2蛋白与血浆INF-γ/IL-4比值存在负相关(P<0.05)。结论:HSP患儿存在TLR2 mRNA和蛋白的水平上调,且伴有肾损害的患儿尤为明显,提示机体内存在免疫表达失衡的情况,TLR2可能参与HSP的免疫发病机制。

Objective: To analyze the expression level of Toll like receptor 2(TLR2) in peripheral blood mononuclear cells of children with Henoch-Schonlein purpura(HSP) and its correlation with plasma gamma-interferon(INF-γ) and interleukin-4(IL-4). Methods: The clinical data of 78 children with HSP were collected by retrospective study. According to whether there was renal damage, they were divided into renal damage group(35 cases) and non renal damage group(43 cases). At the same time, 40 healthy children were selected as the control group. The levels of plasma INF-γ and IL-4 were compared at admission, and the expression of TLR2 protein and mRNA in peripheral blood monocytes were detected. Pearson correlation was used to analyze the relationship between the expression of TLR2 protein in peripheral blood monocytes and the ratio of INF-γ/IL-4 in plasma. Results: Compared with the control group, the plasma INF-γ and the ratio of INF-γ/IL-4 in HSP group were significantly decreased, and the content of IL-4 was significantly increased(P<0.05). Compared with the control group, the expression of TLR2 protein and mRNA in peripheral blood mononuclear cells of HSP group were significantly increased(P<0.05). Compared with the group without renal damage, the expression of TLR2 protein and mRNA in peripheral blood mononuclear cells of HSP children in renal damage group were significantly increased(P<0.05). Pearson correlation analysis showed that TLR2 protein in peripheral blood mononuclear cells was negatively correlated with the ratio of plasma INF-γ/IL-4 in children with HSP and renal damage(P<0.05). Conclusion: The expression of TLR2 protein and mRNA in peripheral blood mononuclear cells were up-regulated in children with HSP, especially in children with renal damage, which suggested that there was imbalance of immune expression in the body and TLR2 might participate in the immune pathogenesis of HSP.