过敏性紫癜患儿TLR4、LTB4、SOCS5表达与Th1和Th2的关系

Relationship between expression of TLR4,LTB4,SOCS5 and Th1,Th2 in children with Henoch-Schonlein purpura

目的 探究Toll样受体4(TLR4)、白三烯B4(LTB4)、细胞因子信号传导抑制蛋白5(SOCS5)与过敏性紫癜(HSP)患儿辅助型T细胞1(Th1)和辅助型T细胞2(Th2)失衡的关系。方法 本研究选取2018年6月至2021年6月河北省唐山市妇幼保健院和开滦总医院接诊的86例HSP患儿作为研究组,包括单纯型20例、混合型66例,根据是否伴有肾损害将混合型HSP患儿分为伴有肾损害组(23例)和未伴有肾损害组(43例)。同时随机选取同期河北省唐山市妇幼保健院和开滦总医院体检健康儿童90例作为对照组。采用酶联免疫吸附试验(ELISA)检测血清LTB4、白细胞介素-4(IL-4)和γ干扰素(IFN-γ)水平;分离试剂盒检测TLR4和SOCS5基因表达。观察研究组和对照组TLR4、LTB4、SOCS5及IL-4和IFN-γ表达水平的差异,分析TLR4、LTB4、SOCS5与IL-4和IFN-γ的相关性。结果 研究组TLR4 mRNA和SOCS5 mRNA均高于对照组(P<0.05);研究组LTB4和IL-4表达水平均高于对照组(P<0.05),IFN-γ表达水平低于对照组(P<0.05);混合型HSP患儿TLR4 mRNA和SOCS5 mRNA均高于单纯型HSP患儿(P<0.05);混合型HSP患儿LTB4和IL-4表达水平均高于单纯型HSP患儿(P<0.05),IFN-γ表达水平低于单纯型HSP患儿(P<0.05);伴有肾损害组TLR4 mRNA和SOCS5 mRNA表达水平均高于未伴有肾损害组(P<0.05);伴有肾损害组LTB4和IL-4表达水平均高于未伴有肾损害组(P<0.05),IFN-γ表达水平低于未伴有肾损害组(P<0.05);TLR4、LTB4和SOCS5表达水平与IFN-γ呈负相关(r=-0.920、-0.935、-0.970,P<0.05);TLR4、LTB4和SOCS5表达与IL-4均呈正相关(r=0.991、0.975、0.973,P<0.05);TLR4、LTB4、SOCS5及IFN-γ和IL-4诊断HSP的受试者工作特征曲线的曲线下面积均在0.750以上,均具有较高的特异度和灵敏度,且联合检测的诊断价值更高。结论 TLR4、LTB4、SOCS5及IL-4在HSP患儿体内均呈高表达,IFN-γ呈低表达,TLR4、LTB4和SOCS5与IL-4呈正相关,与IFN-γ呈负相关,在Th1/Th2失衡中参与反应,可以将其作为HSP诊断的参考依据。

Objective To explore Toll-like receptor 4(TLR4),leukotriene B4(LTB4),inhibitor of cytokine signaling protein 5(SOCS5)and imbalance of helper T cell 1(Th1) and helper T cell 2(Th2)in children with Henoch-Schonlein purpura(HSP).Methods A total of 86 children with HSP admitted to Tangshan Maternal and Child Health Hospital, Hebei Province and Kailuan General Hospital from June 2018 to June 2021 were selected as the study group, including 20 cases of simple type and 66 cases of mixed type.According to whether accompanied by renal damage, children with mixed type of HSP were divided into the group with renal damage(23 cases) and the group without renal damage(43 cases).At the same time, 90 healthy children were randomly selected as the control group.Serum LTB4,interleukin-4(IL-4) and interferon gamma(IFN-γ) levels were detected by enzyme-linked immunosorbent assay(ELISA),TLR4 and SOCS5 gene expressions were detected by isolation kits.Differences in the expression of TLR4,LTB4,SOCS5,IL-4,IFN-γ between the study group and the control group were observed, and the correlation between TLR4,LTB4,SOCS5 and IL-4 and IFN-γ was analyzed.Results TLR4 mRNA and SOCS5 mRNA in the study group were significantly higher than those in the control group(P<0.05).The expressions of LTB4 and IL-4 in the study group were higher than those in the control group(P<0.05),and the expression of IFN-γ was lower than that in the control group(P<0.05).The levels of TLR4 mRNA and SOCS5 mRNA in HSP children with mixed type were higher than those in children with simple type(P<0.05),the expression of LTB4 and IL-4 in HSP children with mixed type was higher than those in children with simple type(P<0.05),and the expression of IFN-γ was lower than that in children with simple type(P<0.05).The expressions of TLR4 mRNA and SOCS5 mRNA in the group with renal damage were higher than those in the group without renal damage(P<0.05),the expressions of LTB4 and IL-4 in the group with renal damage were higher than those in the group without renal damage(P<0.05),and the expression of IFN-γ was lower than that in the group without renal damage(P<0.05).The expressions of TLR4,LTB4 and SOCS5 were negatively correlated with IFN-γ(r=-0.920,-0.935,-0.970,P<0.05);the expressions of TLR4,LTB4 and SOCS5 were positively correlated with IL-4(r=0.991,0.975,0.973,P<0.05).The areas under the receiver operating characteristic curve of TLR4,LTB4,SOCS5,IFN-γ and IL-4 in the diagnosis of HSP were all above 0.750,which showed high specificity and sensitivity, and the combined detection had higher diagnostic value.Conclusion TLR4,LTB4,SOCS5 and IL-4 are all highly expressed in children with HSP,while IFN-γ is lowly expressed.TLR4,LTB4,and SOCS5 are positively correlated with IL-4,but negatively correlated with IFN-γ,they participate in the reaction in Th1/Th2 imbalance, which can be used as a reference for the diagnosis of HSP.