尿毒症患者单个核细胞Toll样受体4表达及意义  

Clinical significance of toll-like receptor 4 expression on the surface of peripheral blood mononuclear cells in uremic patients

作　　者：王尊松[1] 许冬梅[1] 关广聚[2] 崔美玉[1] 魏勇[1] 唐利军[1] 贾晓妍[1] 李文斌[1] 

机构地区：[1]山东大学附属千佛山医院肾内科,济南250014 [2]山东大学第二医院肾内科

出　　处：《中华医学杂志》2010年第34期2389-2391,共3页National Medical Journal of China

摘　　要：目的 探讨尿毒症患者外周血单个核细胞（PBMC）表面Toll样受体4（TLR4）表达的临床意义.方法 用FITC荧光标记的抗TLR4单抗对80例维持性血液透析患者[（随机分为普通透析液组（CD）和超纯透析液组（UPD）]、40例尿毒症非透析患者和40例正常人（对照组）的外周血单个核细胞表面TLR4分子进行免疫荧光染色,应用流式细胞仪检测.结果 （1）普通血液透析组、非透析组、对照组3组间TLR4表达分别为（18.1±3.7）%、（24.5±4.6）%、（31.6±5.8）%差异有统计学意义（P〈0.05）;（2）使用超纯透析液（UPD）与普通透析液（CD）透析6个月时TLR4表达（23.1±3.2）%与（18.1±3.7）%差异有统计学意义（P〈0.05）;普通血液透析3、6、12个月TLR4表达为（22.6±3.9）%、（18.1±3.7）%、（14.7±2.6）%差异有统计学意义（P〈0.05）,使用超纯透析液治疗后TLR4表达略有下降,但差异无统计学意义（P〉0.05）.结论 在尿毒症非透析及透析患者中TLR4表达均降低;使用超纯透析液较普通透析液TLR4表达增多;随普通透析时间延长,TLR4表达减少,使用超纯透析液对TLR4表达无明显影响.Objective To explore the clinical significance of toll-like receptor 4 expression on the surface of peripheral blood mononuclear cells （PBMC） in uremic patients and observe the effect of ultrapure dialysate on the PBMC expression of TLR4 in these patients.Methods Eighty patients on maintenance dialysis were randomly divided into two groups：conventional dialysate group （CD,n=40）,ultrapure dialysate group（UPD,n =40）and 40 uremic patients without dialysis in NH D group.The blood cells from all patients and 40 healthy controls were stained with FITC labeling anti-TLR4 monoclonal antibodies.Samples were collected and analyzed by flow cytometry.Results The expression of TLR4 was significantly lower in CD group （18.1±3.7） than in NHD group （24.5±4.6,P 〈 0.05） and healthy control group （31.6±5.8,P 〈 0.01）.And marked difference existed between CD group （18.1±3.7）and U PD group （23.1 ±3.2,P 〈0.05） at Month 6 post-dialysis.In CD group the expression of TLR4 became significantly smaller as the duration of dialysis increased （P 〈0.05） while in UPD group although the expression of TLR4 became smaller as the duration of dialysis became longer.But the difference was not statistically significant （P 〉0.05）.Conclusion The PBMC expression of TLR4 becomes down-regulated in uremic patients with or without dialysis and its expression is smaller in conventional dialysate group than in ultrapure dialysate group.The conventional dialysate may suppress the expression of TLR4 while the phenomenon is absent in ultrapure dialysate group.

关 键 词：肾功能衰竭 慢性 受体 Toll样 肾透析 天然免疫 

分 类 号：R692.5[医药卫生—泌尿科学]