TLR4在创伤后人外周血单核细胞内的表达变化

EXPRESSION CHANGES OF TLR4 IN HUMAN PERIPHERAL BLOOD MONOCYTE AFTER TRAUMA

目的 :研究人体在创伤条件下 ,外周血单核细胞内内毒素复合受体TLR4mRNA的表达变化 ,观察它们与临床预后的关系。方法 :35例创伤患者 (ISS≥ 9分 )和 14例正常对照 ,采用RT -PCR法扩增TLR4 ,以 β肌动蛋白 (β-actin)的表达作为内参照 ,比较TLR4的表达水平 ;采用鲎试剂法测血浆LPS浓度 ;ELISA法检测血浆TNF -α、IL - 10 ,同时观察患者的预后情况。结果 :所观察的创伤患者中 ,血浆LPS浓度均发生不同程度的升高 ;血浆TNF -α、IL - 10升高 ,分别于创伤后第 3天、第 5天达到峰值 ;TLR4mRNA的表达均降低 ,但预后良好的可在伤后第 5天恢复正常水平 ,预后差的在伤后第 5天仍处于低水平。结论 :创伤可引起内毒素血症 ;创伤后人外周血单核细胞内TLR4mRNA的表达与患者的免疫机能、预后情况密切相关。

Objective:To determine the expression of endotoxin receptor TLR4 mRNA in human peripheral blood monocyte and its relation to clinical outcome in traumatic patients.Methods:Heparinized blood was obtained from 35 traumatic patients (injury severity score, ISS≥9) and 14 control subjects. Total RNA were isolated from these patients' monocytes. RT-PCR was used to detect TLR4 expression. The LPS concentration of plasma was detected by limulus lysate test. Concentration of TNF-α and IL-6 were observed by ELISA.Results:Among these patients, LPS concentration of plasma was elevated .Concentration of TNF-α and IL-6 reached peak at 3 rd day and 5 th day respectively. Expression of TLR4 mRNA decreased after trauma.Uneventful recovery patients had returned to the normal range in the 5 th day after trauma.But paralytic patients and patients who died had never become normal again after trauma.Conclusions:Trauma could cause endotoxemia. The expression of TLR4 mRNA in human peripheral blood monocyte shows close relation to patients' immunological function and the outcome after trauma.