儿童先天性心脏病术后导管相关性血流感染TGF-β1/Smads信号通路表达

Expression of TGF-β1/Smads signaling pathway in congenital heart disease children with postoperative catheter-related bloodstream infection

目的探讨儿童先天性心脏病术后导管相关性血流感染(CRBSI)T辅助细胞17(Th17)/调节性T细胞(Treg)平衡及转化生长因子-β1(TGF-β1)/Smads信号通路的表达及意义。方法选取2019年1月-2021年5月河南省胸科医院收治的96例先天性心脏病手术且术后采取经颈内静脉穿刺中心静脉置管的患儿为研究对象。根据患儿是否发生CRBSI,分为CRBSI组20例和非CRBSI组76例。另选取同期门诊健康体检儿童48名为健康对照组。检测外周血Th17/Treg细胞,血清TGF-β1及Smad2、Smad3水平,单个核细胞TGF-β1及Smad2、Smad3蛋白表达量。检测TGF-β1+869 C/T位点的基因型频率。结果CRBSI组外周血Th17/Treg细胞比值高于非CRBSI组和健康对照组(P<0.05)。CRBSI组血清TGF-β1及Smad2、Smad3水平均高于非CRBSI组和健康对照组(P<0.05)。CRBSI组外周血单个核细胞TGF-β1蛋白、Smad2蛋白、Smad3蛋白表达量均高于非CRBSI组和健康对照组(P<0.05)。CRBSI组TGF-β1+869 C/T位点的CC基因型频率高于非CRBSI组,TT基因型频率低于非CRBSI组(P<0.05)。结论先天性心脏病术后发生CRBSI的分子病理学机制可能与激活TGF-β1/Smads信号通路有关,从而导致Th17/Treg细胞平衡失调。

OBJECTIVE To explore the expressions of helper T cell(Th17)/regulatory T cell(Treg)and transforming growth factor-β1(TGF-β1)/Smads signaling pathway in congenital heart disease children with postoperative catheter-related bloodstream infection(CRBSI).METHODS A total of 96 children with congenital heart disease who underwent internal jugular vein puncture for central venous catheterization in Henan Chest Hospital from Jan 2019 to May 2021 were recruited as the study subjects and divided into the CRBSI group with 20 cases and the non-CRBSI group with 76 cases according to the status of CRBSI,meanwhile,48 healthy children who received physical examination in outpatient department were chosen as the control group.The levels of peripheral blood Th17/Th17/Treg cell,serum TGF-β1,Smad2 and Smad3 as well as expression levels of TGF-β1,Smad2 and Smad3 in mononuclear cells were detected.The frequencies of genotypes at+869 C/T locus of TGF-β1 gene were detected.RESULTS The peripheral blood Th17/Treg ratio of the CRBSI group was higher than that of the non-CRBSI group and the control group(P<0.05).The levels of serum TGF-β1,Smad2 and Smad3 of the CRBSI group were higher than those of the non-CRBSI group and the control group(P<0.05).The expression levels of TGF-β1,Smad2 and Smad3 in peripheral blood mononuclear cells were higher in the CRBSI group than in the non-CRBSI group and the control group(P<0.05).The frequency of CC genotype at+869 C/T locus of TGF-β1 gene was higher in the CRBSI group than in the non-CRBSI group,while the frequency of TT genotype of the CRBSI group was lower than that of the non-CRBSI group(P<0.05).CONCLUSION The molecular pathological mechanisms of postoperative CRBSI in the children with congenital heart disease may be associated with the activation of TGF-β1/Smads signaling pathway,which leads to the imbalance of Th17/Treg.