假体置入患者外周血白细胞Toll样受体2和4的表达  

Toll-like receptor 2 and 4 expression in peripheral blood leukocytes of patients following prosthesis implantation

作　　者：张紫机[1] 康焱[1] 翟齐毅[1] 张浩[1] 张阳春[1] 侯昌禾[1] 李子卿[1] 盛璞义[1,2] 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13期2299-2303,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: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,但其变化规律尚不清楚。目的:观察关节假体置入患者外周血白细胞Toll样受体2,4的表达。方法:选择关节置换患者和同期10例行关节镜检查患者,于入院次日和假体置入后第3天早晨空腹抽取肘静脉血,流式细胞术分析外周血白细胞中Toll样受体2和Toll样受体4的阳性表达,同时送血样至检验科检查白细胞、血沉、C-反应蛋白水平。结果与结论:两组白细胞、血沉、C-反应蛋白均在正常范围内。Toll样受体2,4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;关节置换组术后外周血单核细胞Toll样受体2阳性表达率明显低于术前(P<0.05);关节置换组Toll样受体4、关节镜组Toll样受体2,4手术前后阳性表达率差异无显著性意义(P>0.05)。关节置换组手术前后外周血单核细胞Toll样受体2阳性表达率低于关节镜组(P<0.05),两组Toll样受体4表达率无差异。提示在无感染的情况下,手术本身应激和局部损伤不影响Toll样受体2,4的表达,假体的置入下调了外周血Toll样受体2的表达。BACKGROUND： Toll-like receptors （TLRs） are expressed on the surface of biofilms in loosening hip prosthesis. However, the expression changes remain unclear. OBJECTIVE： To investigate the expression of TLR 2 and 4 in leukocytes of patients undergoing joint prosthesis implantation. METHODS： Fasting blood plasma samples were harvested from elbow veins 24 hours post admission and 3 days post-operation from patients undergoing arthroplasty or arthroscopy （n=10）. Cell-associated TLR 2 and 4 was measured by flow cytometry, white blood cells, C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） were tested. RESULTS AND CONCLUSION： WBC, ESR, CRP were at normal level in both groups. TLR2 and 4 were mostly expressed in monocytes of peripheral blood, with low expression levels in lymphocytes and neutrophils. The expression levels of TLR2 was significantly reduced following operation （P〈0.05）, but no significant difference was observed in the expression levels of TLR4 in arthroplasty group or TLR2 and 4 in arthroscopy group between post-operation and pre-operation （P〉0.05）, whereas a significant change of TLR9 expression gap was found in arthroplasty patients before and after the procedure （P〈0.05）. TLR 4 expression remained unchanged （P〉0.05）. The TLR2 positive expression rate in monocytes of peripheral blood was significantly lower in arthroplasty group compared with arthroscopy group （P〈0.05）, but no difference was found in TLR4 expression. Resutts show that in the absence of clinical infection, stress and tissue damage during arthroplasty and arthroscopy do not affect TLR2 and 4 expression, but TLR2 expression was downregulated following 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]