慢性乙型肝炎患者肝脏组织TOLL样受体4的变化和意义

目的 通过检测慢性乙型肝炎(CHB)患者肝组织Toll样受体4(TLR4)的表达变化及其与肝脏病理、临床分度、血清HBV DNA对数值等的关系,探讨TLR4在CHB的意义.方法 采用Elivision二步免疫组织化学方法 检测75例CHB及10例健康对照组肝组织TLR4的表达并予以评分,然后与肝脏病理炎症分级及纤维化分期、临床分度和血清HBV DNA对数值[Lg(血清HBVDNA)]等进行相关性分析.结果健康对照组肝组织无或仅有少量TLR4的表达,CHB组肝组织TLR4的表达明显增强并显著高于健康对照组;在轻、中和重度慢性乙型肝炎患者肝组织TLR4表达强度记分分别为(1.0±0.5),(2.3±0.5)和(2.9±0.4)分,随着临床分度的增加,CHB肝组织上的TLR4表达逐步显著升高(F=104.8,P<0.01,两两间比较均P<0.05),肝组织免疫组化染色强度与临床分度间呈正相关(r=0.838,P<0.01);TLR4的表达强度与肝组织炎症活动度分级(G)呈正相关(r=0.579,P<0.05);但与Lg(血清HBV DNA)以及肝组织纤维化分期(S)均无相关.结论 CHB患者肝细胞TLR4表达上调,TLR4可能与CHB的发病有关.

Elevated Toll-like receptor 4 (TLR4) in hepatocytes in patients with chronic hepatitis B and its clinical significance

Objective To investigate the role of TLR4 in the pathogenesis of chronic hepatitis B(CHB) by study the expression of TLR4 in liver tissues in patients with CHB, and the relationship among TLR4 and serum HBV DNA level, clinical severity degrees and histo-logical grades and stages. Methods Expression of TLR4 in liver tissues was semi-quantitatively determined by immunohistochemistry and e-valuated by a scoring system in 75 patients with CHB and 10 health controls. Results The positive staining of TLR4 mainly located in the cytoplasm and some on cell membrane of bepatocytes. Expression of TLR4 in the liver tissues of patients with CHB was stronger than that of health controls. The scores of TLR4 expression in patients with mild, moderate and severe CHB were 1.0±0.5,2.3±0.5 and 2.9±0.4. The scores increased gradually and significantly along with the increase of clinical severity degrees( F = 104.8, P<0.01). The scores of TLR4 expression in the liver tissues of patients with CHB were positively correlated with the clinical severity degrees (r=0.838, P<0.01) and histological grades (r=0.579, P<0.05), but not correlated with Lg (serum HBV DNA) or histological stages. Conclusion TLR4 was up-regulated in the hepatocytes of patients with CHB. There may be a role of TLR4 in the pathogenesis of CHB.