Shan Xiao-ou, Wu Ying, Ye Jing, Ding Zhi-yong, Qian Cai, Zhou Ai-hua
Pediatric Emergency Department, Affiliated Yuying Children's Hospital of Wenzhou Medical College, Wenzhou 325003, China.
Zhonghua Er Ke Za Zhi. 2010 Jan;48(1):15-8.
Sepsis remains a serious clinical problem because of high morbidity and mortality. The importance of Toll-like receptors (TLRs) for the induction of immune responses against sepsis was demonstrated in humans. The present study aimed to probe the gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in patients with sepsis among Chinese Han children in Wenzhou, and investigate the correlation with sepsis.
This study was conducted as a case-control study. Using polymerase chain reaction and DNA sequencing, gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in 59 children with sepsis, 38 children with severe sepsis (including 20 septic shock) and 57 healthy controls were analyzed. Hardy-Weinberg method of statistics was used to compare the frequency of genotypes alleles among three groups.
The mutant genotypes of TLR4 gene (Asp299Gly and Thr399Ile) were not found among sepsis, septic shock and control groups. In severe sepsis group, the Arg753Gln TLR2 polymorphism occurred in 2 out of 38 severe sepsis patients and both of the subjects with the TLR2 Arg753Gln polymorphism had fatal staphylococcal infections.
TLR4 gene (Asp299Gly and Thr399Ile) polymorphisms may not be correlated with susceptibility to sepsis among Chinese Han children in Wenzhou. The fact that only 2 out of 38 severe sepsis patients had Arg753Gln TLR2 polymorphism suggests that a larger sample size is needed because of the rarity of the TLR2 allele among Chinese Han children in Wenzhou.
由于高发病率和死亡率,脓毒症仍然是一个严重的临床问题。Toll样受体(TLR)在诱导针对脓毒症的免疫反应中的重要性已在人类中得到证实。本研究旨在探讨温州汉族儿童脓毒症患者中TLR4(Asp299Gly和Thr399Ile)和TLR2(Arg753Gln)的基因多态性,并研究其与脓毒症的相关性。
本研究为病例对照研究。采用聚合酶链反应和DNA测序技术,分析了59例脓毒症患儿、38例严重脓毒症患儿(包括20例感染性休克患儿)和57例健康对照者的TLR4(Asp299Gly和Thr399Ile)及TLR2(Arg753Gln)基因多态性。采用Hardy-Weinberg统计学方法比较三组基因型等位基因频率。
在脓毒症组、感染性休克组和对照组中均未发现TLR4基因的突变基因型(Asp299Gly和Thr399Ile)。在严重脓毒症组中,38例严重脓毒症患者中有2例出现TLR2的Arg753Gln多态性,且这2例具有TLR2 Arg753Gln多态性的患者均发生了致命的葡萄球菌感染。
温州汉族儿童中,TLR4基因(Asp299Gly和Thr399Ile)多态性可能与脓毒症易感性无关。38例严重脓毒症患者中只有2例出现TLR2的Arg753Gln多态性,这表明由于温州汉族儿童中TLR2等位基因罕见,需要更大的样本量。