胸腔积液中可溶性 Toll 样受体的表达。

Expression of soluble Toll-like receptors in pleural effusions.

机构信息

Department of Microbiology, Guangxi Medical University, China.

出版信息

Chin Med J (Engl). 2010 Aug;123(16):2225-30.

PMID:20819670

Abstract

BACKGROUND

The Toll-like receptors (TLRs) represent a group of single-pass transmembrane receptors expressed on sentinel cells that are central to innate immune responses.The aim of this study was to investigate the presence of soluble TLRs in pleural effusions, and the diagnostic values of TLRs for pleural effusion with various etiologies.

METHODS

Pleural effusion and serum samples were collected from 102 patients (36 with malignant pleural effusion, 36 with tuberculous pleural effusion, 18 with bacterial pleural effusion, and 12 with transudative pleural effusion). The concentrations of TLR1 to TLR10 were determined in effusion and serum samples by enzyme linked immunosorbent assay. Four classical parameters (protein, lactate dehydrogenase, glucose and C-reactive protein (CRP)) in the pleural fluid were also assessed. Receiver-operating characteristic curves were used to assess the sensitivity and specificity of pleural fluid TLRs and biochemical parameters for differentiating bacterial pleural effusion.

RESULTS

The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 in bacterial pleural effusion were significantly higher than those in malignant, tuberculous, and transudative groups, respectively. Analysis of receiver operating characteristic curves revealed that the area under the curves of TLR1, TLR3, TLR4, TLR7 and TLR9 were 0.831, 0.843, 0.842, 0.883 and 0.786, respectively, suggesting that these TLRs play a role in the diagnosis of bacterial pleural effusion. Also, the diagnostic value of TLRs for bacterial pleural effusions was much better than that of biochemical parameters (protein, lactate dehydrogenase, glucose and CRP).

CONCLUSIONS

The concentrations of TLR1, TLR3, TLR4, TLR7 and TLR9 appeared to be increased in bacterial pleural effusion compared to non-bacterial pleural effusions. Determination of these pleural TLRs may improve the ability of clinicians to differentiate pleural effusion patients of bacterial origin from those with other etiologies.

摘要

背景

Toll 样受体（TLR）是一组表达在哨兵细胞上的单次跨膜受体，是固有免疫反应的核心。本研究旨在探讨 TLR 在胸腔积液中的可溶性表达及其对不同病因胸腔积液的诊断价值。

方法

收集 102 例患者（恶性胸腔积液 36 例、结核性胸腔积液 36 例、细菌性胸腔积液 18 例、渗出性胸腔积液 12 例）的胸腔积液和血清样本。采用酶联免疫吸附试验检测 TLR1 至 TLR10 在胸腔积液和血清中的浓度。同时检测胸腔积液中 4 项经典参数（蛋白、乳酸脱氢酶、葡萄糖和 C 反应蛋白（CRP））。采用受试者工作特征曲线评估胸腔积液 TLR 和生化参数对鉴别细菌性胸腔积液的敏感性和特异性。

结果

细菌性胸腔积液中 TLR1、TLR3、TLR4、TLR7 和 TLR9 的浓度明显高于恶性、结核性和渗出性胸腔积液组。受试者工作特征曲线分析显示，TLR1、TLR3、TLR4、TLR7 和 TLR9 的曲线下面积分别为 0.831、0.843、0.842、0.883 和 0.786，提示这些 TLR 对细菌性胸腔积液的诊断有一定作用。此外，TLRs 对细菌性胸腔积液的诊断价值明显优于生化参数（蛋白、乳酸脱氢酶、葡萄糖和 CRP）。