Xiong Jing, Wang Yang, Zhu Zhonghua, Liu Jianshe
Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
J Huazhong Univ Sci Technolog Med Sci. 2006;26(5):570-2. doi: 10.1007/s11596-006-0523-6.
The changes of Toll-like receptor (TLR) 2, 4 of peripheral blood mononuclear cells (PBMCs) in the acute abdomen patients associated with systemic inflammatory response syndrome (SIRS) and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-alpha and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group (P<0.01). TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-alpha could be detected with low value in normal controls, but they were up-regulated markedly on the 1st day after admission. Then TLR4 mRNA, IL-6 and TNF-alpha were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group (P<0.01). The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-alpha and IL-6, and the hospital stay. The results of Logistic regression demonstrated that overexpression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome (MODS). It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.
探讨全身炎症反应综合征（SIRS）相关急腹症患者外周血单个核细胞（PBMCs）中Toll样受体（TLR）2、4的变化及其潜在意义。对103例急腹症患者进行临床研究，其中65例合并SIRS。40名健康个体作为正常对照。采用RT-PCR检测TLR2、4的mRNA表达，ELISA法检测TNF-α和IL-6的表达。检测血浆内毒素水平、住院时间和死亡率。结果发现，所有急腹症患者内毒素水平均有不同程度升高，SIRS组内毒素水平及住院时间均长于非SIRS组（P<0.01）。正常对照中可检测到低水平的TLR2 mRNA、TLR4 mRNA、IL-6和TNF-α，但入院第1天它们明显上调。随后TLR4 mRNA、IL-6和TNF-α逐渐下降，但TLR2 mRNA直至第5天维持在高水平。SIRS组上述指标高于非SIRS组（P<0.01）。相关性分析结果显示，TLR2、4 mRNA的表达与TNF-α、IL-6水平及住院时间呈正相关。Logistic回归结果表明，TLR2、4 mRNA过表达可能导致多器官功能障碍综合征（MODS）风险增加。结论：在合并SIRS的急腹症患者中，PBMCs中TLR2、4的表达明显增加，提示TLR可能在SIRS相关急腹症的发病机制中起重要作用。
