乙型肝炎肝硬化患者外周血Toll样受体2和4及CD4+CD25+调节性T细胞的变化

目的 检测乙型肝炎肝硬化患者外周血单个核细胞(peripheral blood mononuelear cells,PBMCs)表面Toll样受体(Toll-like receptor,TLR)2和TLR4以及CD4+CD25+调节性T细胞(regulato-ry T cells,Treg)的表达,并探讨TLR2、TLR4与Treg的相关性.方法 分别应用抗-TLR2-PE、抗-TLR4-APC、抗-CD14-FITC及抗-CD4-PerCP、抗-CD25-FITC、扰-CD127-PE对67例研究对象乙型肝炎肝硬化患者(HBV related liver cirrhosis,LC)30例、慢性乙型肝炎患者(chronic hepatitis B,CHB)21例、健康对照(normal control,Nc)16例]PBMCs表面分子进行免疫荧光染色,应用流式细胞仪分别对TLR2、TLR4及Treg进行检测.组间比较采用Kruskal-wallis秩和检验,相关性分析采用Spearman秩相关.结果 LC组、CHB组、NC组单核细胞表面TLR2、TLR4的平均荧光强度(MFI)分别为200.3±96.8和32.1±7.2、214.0±72.6和25.2 ±8.3、94.1 ±17.6和17.8 ±3.9.LC组与NC组、CHB组与NC组TLR2 MFI比较差异均有统计学意义(P<0.05),LC组与CHB组TLR2 MFI差异无统计学意义(P>0.05).LC组与NC组、CHB组与NC、LC与NC组TLR4 MFI比较差异均有统计学意义(P<0.05).LC组、CHB组、Nc组Treg占CD4+T淋巴细胞的比例分别为(5.07%±1.43%、5.88%±1.66%、4.21%±1.24%),CHB组与NC组、CHB组与LC组比较差异有统计学意义(P<0.05),而LC组与NC组比较差异无统计学意义(P>0.05).在LC组,TLR4的表达与Treg呈正相关(r=0.469,P=0.032),TLR2与血清病毒载量呈负相关(r=-0.428,P=0.021).结论 LC患者,TLR2、TLR4的表达显著上调,TLR2、TLR4可能与乙型肝炎肝硬化的发生有关.

Detection of circulating Toll-like receptor 2 and 4 and CD4 + CD25 + regulatory T cells in patients with HBV-related liver cirrhosis

Objective To detect circulating CD4 + CD25 + regulatory T cells (Treg) and Toll-like receptor(TLR)2 and TLR4 expression on the peripheral blood mononuclear cells (PBMCs) of patients with HBV-related liver cirrhosis (LC), and to explore the correlation between them. Methods PBMCs isolated from 30 LC patients, 21 chronic hepatitis B (CHB) patients and 16 normal controls(NC) were stained with fluorescent labeling anti-TLR2-PE, anti-TLR4-APC, anti-CD14-FITC monoclonal antibodies and anti-CD4-PerCP, anti-CD25-FITC, anti-CD127-PE. Samples were detected by flow cytometry. Statistic analysis be-tween groups was performed by Kruskal-Wallis H test. Spearman rank correlation was used to analyze the correlation of Treg and TLR2, TLR4. Results The expression of TLR2 and TLR4 were significantly up-reg-ulated in patients with LC than those in the controls (TLR2 : 200.3 ± 96.8 vs 94.1 ± 17.6, P < 0.05 ; TLR4:32.1 ±7.2 vs 17.8 ±3.9, P<0.05). The expression of TLR4 was significantly increased in pa-tients with LC than those in patients with CHB (TLR4 : 32. 1 ± 7.2 vs 25.2 ± 8.3, P < 0.05), but there were no differences of TLR2 expression between LC and CHB(200.3 ± 96.8 vs 214.0 ± 72.6, P > 0.05). Treg/CD4+ T cells were 5.07% ±1.43%, 5.88% ±1.66%, 4.21% ±1.24% in patients with LC, CHB and NC, respectively. Treg/CD4+ T cells were significantly increased in patients with CHB than those in pa-tients with NC(P<0. 05) and LC(P <0.05), but there were no differences between LC and NC(P > 0.05). TLR4 expression and Treg were positive correlation (r = 0. 469, P = 0. 032) and TLB2 expression were negative correlation in patients with LC (r = -0.428, P = 0.021). Conclusion The expression of TLR2 and TLR4 were up-regulated on PBMCs in patients with LC. It seems to be expression of TLR2 and TLR4 in-volved in the pathogenesis of LC.