手足口病患儿外周血单个核细胞中TLR4通路检测与病情、炎症反应、免疫功能的关系

目的研究手足口病(HFMD)患儿外周血单个核细胞(PBMCs)中Toll样受体4(TLR4)通路与病情、炎症反应、免疫功能的关系。方法回顾性选择2016年7月至2019年4月期间在中国医科大学附属第一医院诊断为HFMD的患儿并根据病情分为轻症组和重症组,另取同期体检的健康儿童作为对照组。测定各组对象PBMCs中TLR4、核因子κB(NF-κB)的表达水平,血清中炎症细胞因子、免疫球蛋白的含量,外周血中免疫细胞的含量。分析HFMD患儿TLR4的表达水平与血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IgM、IgG、IgA、CD3^+CD4^+T细胞、CD3^+CD8^+T细胞、CD19^+B细胞的相关性。结果重症组和轻症组患儿PBMCs中TLR4、NF-κB的mRNA相对表达水平及血清中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、免疫球蛋白M(IgM)的含量均明显高于对照组血清中IgG、IgA的含量及外周血中CD3^+CD4^+T细胞、CD3^+CD^8^+T细胞、CD19^+B细胞的含量均明显低于对照组(P <0.05),且重症组患者上述指标的变化较轻症组更为显著(P <0.05);TLR4与CRP、TNF-α、IL-6、IgM呈正相关,与IgG、IgA、CD3^+CD4^+T细胞、CD3^+CD8^+T细胞、CD19^+B细胞呈负相关。结论手足口病患儿PBMCs中TLR4通路的过度激活与病情加重、炎症反应激活、免疫功能紊乱有关。

Detection of TLR4 pathway in peripheral blood mononuclear cells of children with hand-foot-mouth disease and its relationship with disease,inflammatory response and immune function

Objective To study the Toll-like receptor 4(TLR4) Pathway in peripheral blood mononuclear cells(PBMCs) of Children with hand-foot-mouth disease(HFMD) and its relationship with disease,inflammatory response and immune function.Methods Children with HFMD diagnosed in our hospital from July 2016 to April 2019 were divided into mild group and severe group according to their condition,and healthy children who underwent physical examination at the same time were selected as control group.The levels of TLR4 and NF-κB in PBMCs,inflammatory cytokines and immunoglobulin in serum,immune cells in peripheral blood were measured.TLR4 expression in children with HFMD and serum C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),IgM,IgG,IgA,CD3^+CD4^+T cells,CD3^+The correlation of CD8^+T cells and CD19^+B cells was analyzed.Results The relative expression levels of TLR4 and NF-κB in PBMCs and the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),immunoglobulin M(IgM) in serum in severe group andmild group were significantly higher than those in control group,the contents of CD3^+CD4^+T,CD3^+CD8^+T cells and CD19^+B cells in peripheral bloodwere significantly lowerthan those in control group(P <0.05) and the changes of these indexes in severe group were more significant than those in mild group(P <0.05).TLR4 was positively correlated with CRP,TNF-α,IL-6 and IgM,negatively correlated with IgG,IgA,CD3^+CD4^+T cells,CD3^+CD8^+T cells and CD19^+B cells.Conclusion Overactivation of TLR4 pathway in PBMCs of children with HFMD correlates with aggravation of disease,activation of inflammatory response and disturbance of immune function.