Toll样受体2和Toll样受体4在慢性鼻-鼻窦炎中的表达及意义

目的：通过检测天然免疫因子Toll样受体2（TLR2）和Toll样受体4（TLR4）在慢性鼻-鼻窦炎不同临床分型以及对照组中的表达情况,探讨TLR在慢性鼻-鼻窦炎发病机制中的作用。方法：采用免疫组织化学方法分别检测TLR2和TLR4在慢性鼻-鼻窦炎伴鼻息肉组（A组,21例）,慢性鼻-鼻窦炎无鼻息肉组（B组,15例）,复发性慢性鼻-鼻窦炎伴鼻息肉组（C组,11例）及对照组（D组,13例）中的表达情况。显微镜下计数阳性细胞表达情况,等级资料采用Mann-Whitney U进行统计分析,组间用单因素的方差进行统计分析。结果：1TLR2和TLR4有相同的表达特点,主要表达部位集中在上皮基膜全层、腺体细胞的细胞质及极少数炎性细胞,如单核细胞和浆细胞的细胞质,偶有不明细胞的细胞核阳性表达;2A、B、C、D组鼻腔黏膜组织中TLR2的表达分别为10.18±16.80、27.00±12.07、7.55±14.69、9.40±17.83,A、C、D组与B组比较,均差异有统计学意义（均P〈0.05）;3A、B、C、D组鼻腔黏膜组织中TLR4的表达分别为11.30±19.22、36.02±17.75、8.51±9.22、7.75±4.49,A、C、D组与B组比较,均差异有统计学意义（均P〈0.05）。结论：鼻腔黏膜上皮能产生天然免疫因子TLR2和TLR4;TLR2和TLR4在慢性鼻-鼻窦炎各临床表型中的差异性表达提示其在慢性鼻-鼻窦炎的发病中发挥了一定作用。

Expression and significance of Toll like receptor 2 and Toll like receptor 4 in chronic rhinosinusitis

Objective：To explore the role of the innate immune factors TLR2 and TLR4 in the pathogenesis of chronic rhinosinusitis（CRS） by detecting their expression in different clinical types of CRS and the normal control group. Method： Immunohistochemistry was used to detect the expression of TLR2 and TLR4 respectively in 21 cases （chronic rhinosinusitis with nasal polyps, CRSwNP） group, 15 cases （chronic rhinosinusitis without nasal polyos, CRSsNP） group, 11 cases recurrent CRSwNP group and 13 cases control group. Positive cells were coun- ted under the microscope artificially, Mann-Whitney U analysis was applied for the ranked data, and one-way ano- va analysis was adopted to analyze the experimental group and control group. Result：（D TLR2 and TLR4 expres- sion had the same characteristics. Expression mainly concentrated in parts of the whole layer of epithelial basement membrane, cytoplasm of glandular cells, very few inflammatory cells such as monocytes and plasma cells in the cy- toplasm, sometimes unknown cell nuclei positive expression. （2） The glandular cells were stained manual counting and color grading. TLR2 and TLR4 packet application Wilcoxon rank test Mann-Whitney U test analysis was not statistically significant （P〉0.05）, measurement data within the group variance statistical difference between the groups （P〈0.05）. Conclusion：The Nasal mucosa can produce the innate immune factors TLR2 and TLR4. The different expression of TLR2 and TLR4 in the various clinical types of CRS suggests that they play the certain role in the pathogenesis of CRS.