UPEC尿路感染外周血NLRP3和NLRC4及下游细胞因子水平

Analysis of peripheral blood NLRP3,NLRC4 and downstream cytokine levels in patients with UPEC urinary tract infection

目的探讨泌尿外科尿路致病性大肠埃希菌所致尿路感染患者外周血NOD样受体蛋白3(NLRP3)、核效应蛋白4(NLRC4)及其下游细胞因子水平。方法选择邢台市人民医院泌尿外科2018年9月-2019年12月进行手术并在术后发生尿路致病性大肠埃希菌(UPEC)尿路感染患者50例为研究组,选择同期医院体检健康人50名作为对照组。术后收集中段尿进行病原培养,对UPEC耐药特点进行检测。采用实时荧光定量聚合酶链式反应(RT-PCR)检测NLRP3、NLRC4在mRNA上的相对表达,结果计算采用2^(-ΔΔct)法。采用酶联免疫吸附法(ELISA)检测血清中干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及单核细胞趋化蛋白-1(MCP-1)水平。结果50株检出的UPEC对左氧氟沙星、呋喃妥因、磷霉素、阿莫西林/克拉维酸、呋喃妥因耐药率分别为44.00%、16.00%、2.00%、12.00%,40.00%;研究组NLRP3、NLRC4 mRNA和血清IFN-γ、IL-6、IL-8、MCP-1水平高于对照组(P<0.05);反复发作组NLRP3、NLRC4 mRNA和血清IFN-γ、IL-6、IL-8、MCP-1水平高于非反复发作组,差异均具有统计学意义(P<0.05)。结论NLRP3和NLRC4所参与的细胞焦亡过程可能影响了UPEC致尿路感染的进程,对于复发感染有一定影响,但与耐药性出现无关。

OBJECTIVE To investigate the change of peripheral blood NOD-like receptor protein 3(NLRP3),nuclear effector protein 4(Nuclear effector protein 4,NLRC4)and the downstream cytokines in peripheral blood of patients with urinary tract infections caused by urinary tract pathogenic Escherichia coli.METHODS Total of 50 patients with UPEC urinary tract infection who underwent surgery in Xingtai People's Hospital from Sep 2018 to Dec 2019 were recruited as the research group,and 50 healthy people who was under physical examination in the hospital during the same period were in the control group.After the operation,the mid-section urine was collected for pathogen culture,and be used to detect the characteristics of UPEC resistance.Real-time Quantitive Polymerase Chain Reaction(RT-PCR)was used to detect the relative mRNA expression of NLRP3 and NLRC4,and the results were calculated by using the 2^(-ΔΔct) method.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum interferon-γ(Interferon-γ,IFN-γ),interleukin-6(Interleukin-6,IL-6),interleukin Interleukin-8(IL-8)and Monocyte Chemotactic Protein-1(MCP-1)levels.RESULTS The drug resistance rates of 50 UPEC strains to levofloxacin,nitrofurantoin,fosfomycin tromethamine,amoxicillin/potassium clavulanate and nitrofurantoin were 44.00%,16.00%,2.00%,12.00%and 40.00%,respectively.The mRNA levels of NLRP3,NLRC4 and serum IFN-γ,IL-6,IL-8 and MCP-1 levels in the research group were significantly higher than those in the control group(P<0.05);the mRNA levels of NLRP3,NLRC4 and serum IFN-γ,IL-6 and IL-6 levels in the recurrent attacks group were significantly higher than that in the non-recurrent group(P<0.05).CONCLUSION NLRP3 and NLRC4 participating in the pyrolysis process may affect the process of UPEC-induced urinary tract infection,and have a certain impact on recurrent infection,but have nothing to do with the emergence of drug resistance.