关节置换后外周血白细胞中Toll样受体4和9的表达  

Toll-like receptors 4 and 9 expression in leukocytes following joint arthroplasty

作　　者：张紫机[1] 康焱[1] 盛璞义[1,2] 翟齐毅[2] 张浩[1] 张阳春[2] 侯昌禾[2] 李子卿[2] 廖威明[1] 

机构地区：[1]中山大学附属第一医院关节外科,广东省广州市510080 [2]中山大学附属第一医院黄埔关节外科中心,广东省广州市510700

出　　处：《中国组织工程研究与临床康复》2011年第4期575-579,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：广东省科委国际合作项目(2006B50107004);广东省科委科技计划项目(2007B010600048);芬兰坦佩雷大学科研基金项目(9J114)~~

摘　　要：背景:目前对关节置换后机体内Toll样受体变化和相关机制研究甚少,有研究证实全髋关节置换后松动假体表面生物膜中表达Toll样受体。目的:观察关节假体置入后Toll样受体4,9在关节置换者外周血白细胞上的表达。方法:实验组选择11例行关节置换患者,对照组为10例行关节镜检查患者,于入院次日和术后第3天早晨空腹采血,流式细胞术分析外周血白细胞中Toll样受体4,9的阳性表达,同时送血样至检验科检查白细胞计数、血细胞沉降率、C-反应蛋白水平。结果与结论:两组白细胞计数、血细胞沉降率、C-反应蛋白均在正常范围内。Toll样受体4,9均主要表达于外周血单核细胞,而在外周血淋巴细胞和中性粒细胞的表达率较低;两组患者干预后Toll样受体4,9在外周血单核细胞阳性表达率较置换前明显降低(P>0.05)。实验组患者Toll样受体9置换前后外周血单核细胞阳性表达率的变化明显大于关节镜组(P<0.05);而Toll样受体4变化差异无显著性意义(P>0.05)。说明在无感染的情况下,手术本身的应激和局部损伤不影响Toll样受体4,9的表达,假体置入则下调外周血白细胞对Toll样受体9的表达。BACKGROUND：Little researches focus on the expression of Toll-like receptors （TLRs） and its mechanism in arthroplasty patients.Evidence shows TLRs are expressed on the surface of biofilms in loosening hip prosthesis.OBJECTIVE：To investigate the differences in TLRs 4 and 9 expression in leukocytes of patients with and without prosthesis.METHODS：Fasting blood plasma samples were harvested 24 hours post admission and 3 days post-operation from patients undergoing arthroplasty （n=11） or arthroscopy （n=10）.Cell-associated TLR 4 and 9 was measured by flow cytometry,white blood cells,C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were tested.RESULTS AND CONCLUSIONS：WBC,ESR,CRP were at normal level in both groups.TLR4 and 9 were mostly expressed in monocytes of peripheral blood,with low expression levels in lymphocytes and neutrophils.The expression levels of TLR 4 and TLR 9 were of no significance between post-operation and pre-operation in both groups （P0.05）,whereas a significant change of TLR9 expression gap was found in arthroplasty patients before and after the procedure （P0.05）.TLR 4 expression remained unchanged （P0.05）.Results showed that in the absence of clinical infection,stress and tissue damage during arthroplasty and arthroscopy did not affect TLR4 and TLR9.TLR9 seems to be downgraded by implantation of joint prosthesis.

关 键 词：关节置换 假体 TOLL样受体 流式细胞术 人工假体 

分 类 号：R318[医药卫生—生物医学工程]