强直性脊柱炎和类风湿关节炎患者外周血单个核细胞中Toll样受体4基因的表达及临床意义

目的探讨Toll样受体4(TLR4)mRNA在强直性脊柱炎(AS)、类风湿关节炎(RA)患者以及健康个体外周血单个核细胞(PBMC)中的表达差异及其临床意义。方法应用实时荧光定量逆转录聚合酶链反应(RT-PCR)检测2006年3月至10月第二军医大学附属长征医院60例AS患者、20例RA患者及30例健康对照PBMC中TLR4 mRNA的表达水平;应用ESR自动化分析仪和特定蛋白电泳仪分别测定红细胞沉降率(ESR)和血浆C-反应蛋白(CRP)。结果AS和RA患者PBMCTLR4 mRNA的表达水平明显高于对照组,但两疾病组之间差异并无显著性意义;人类白细胞抗原(HLA-B27)阳性和阴性AS患者均显著高于健康对照组,且HLA-B27阳性AS患者显著高于RA组,但两组AS患者以及HLA-B27阴性AS与RA患者之间,TLR4 mRNA差异无显著性意义;在HLA-B27阳性AS患者中,TLR4 mRNA的表达与ESR及CRP呈显著相关性,但在HLA-B27阴性AS患者中则无这种相关性。在RA患者中,TLR4 mRNA与CRP呈显著相关性。结论AS和RA患者PBMCTLR4 mRNA的表达均上调,AS患者上调与HLA-B27阳性与否无关,但HLA-B27阳性AS患者比RA上调更明显,且HLA-B27抗原影响AS患者TLR4 mRNA与ESR及CRP的相关性。TLR4的异常表达可能在AS和RA的发生和发展中起作用。

Analysis on the expression of Toll-like receptor 4 mRNA in peripheral blood mononuclear cells from the patients with ankylosing spondylitis and rheumatoid arthritis and its clinical significance

Objective To explore the differential expression of Toll-like receptor 4(TLR4)mRNA in peripheral blood mononuclear cells(PBMCs)between the patients with ankylosing spondylitis(AS),rheumatoid arthritis(RA)and the healthy individuals as well as its clinical significance.Methods The expression level of TLR4 mRNA in PBMCs was determined from 60 AS patients,30 RA patients and 30 healthy controls by real-time fluorescence quantitative RT-PCR.Erythrocyte sedimentation rate(ESR)and plasma C-reactive protein(CRP)were detected automatically respectively by ESR automatic analyzer and specific protein electrophoresis analyzer.Results The expression level of TLR4 mRNA in PBMC was significantly higher in patients with AS or RA than in the controls,while no significant difference was observed between the two disease groups.Furthermore,both HLA-B27-positive and -negative AS patients showed higher TLR4 mRNA level than healthy controls,and HLA-B27-positive AS patients higher than RA patients.However,there was no significant difference between HLA-B27-positive,-negative AS and RA patients.In HLA-B27-positive AS patients,close correlations between TLR4 mRNA and ESR or CRP were observed,but no correlation observed in HLA-B27 negative patients.In RA patients,the level of TLR4 mRNA correlated with CRP.Conclusion The expression level of TLR4 mRNA is elevated in PBMC from either AS or RA patients.Although the upregulation of TLR4 mRNA is not associated with whether HLA-B27 is positive or not in AS patients,it is more significant in HLA-B27-positive AS than in RA.Furthermore,the correlations between the expression of TLR4 mRNA and ESR or CRP are influenced by HLA-B27 antigen in AS patients.In conclusion,the present results indicate that the abnormal expression of TLR4 might play a role in the development and progression of AS and RA.