紫癜性肾炎患儿外周血单核细胞Toll样受体3和Toll样受体4表达的意义  

Expression of Toll-like receptor 3 and Toll-like receptor 4 in peripheral blood mononuclear cells from Henoch- Schonlein purpura nephritis in children and its clinical significance

作　　者：常红[1] 刘秀琴 张秋业[1] 程娜[1] 张守青[1] 林毅[1] 

机构地区：[1]青岛大学附属医院心肾免疫儿科,266003 [2]青岛市立医院儿内科

出　　处：《中华实用儿科临床杂志》2014年第5期347-350,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：山东省优秀中青年科学家科研奖励基金（BS2011SW006）;青岛市科技局公共领域科技支撑计划项目[2012-1-3-2-（19）-nsh]

摘　　要：目的探讨Toll样受体（TLR）3、4在紫癜性肾炎（HSPN）患儿外周血单核细胞的表达及临床意义。方法选择青岛大学附属医院首次住院的过敏性紫癜（HSP）患儿105例，依据是否合并。肾损害及24h尿蛋白定量，将患儿分为HSP无。肾脏损害组（A组），HSPN无蛋白尿组（B组），HSPN蛋白尿组（c组）；另取青岛大学附属医院健康体检儿童30例作为健康对照组（N组）。采用流式细胞术及实时荧光定量聚合酶链反应（real．timePCR）检测外周血单核细胞的TLR3，4蛋白及mRNA的表达。结果1．A组、B组、c组外周血单核细胞TLR4mRNA及蛋白表达均显著高于N组（F=37．33、24．01，P均〈0．05）；C组TLR4mRNA及蛋白表达显著高于A组和B组（P均〈0．05），A组和B组TLR4mRNA及蛋白表达比较差异均无统计学意义（P均〉0．05）。2．C组TLR4蛋白表达与24h尿蛋白定量呈正相关（r=0．69，P〈0．01）。3．TLR3的蛋白及mRNA表达在A、B、c、N组无统计学差异（F=0．86、1．78，P均〉0．05）。4．HSP患儿外周血单核细胞TLR4mRNA表达与TLR4蛋白表达呈正相关（r=0．61，P〈0．01）。结论HSPN患儿外周血单核细胞TLR4表达水平显著上调，且与尿蛋白排泄量呈正相关，提示TLR4持续异常活化可能参与了HSPN的发病过程。Objective To explore the expressions and clinical significance of Toll-like receptor （TLR） 3 and TLR4 in peripheral blood mononuclear cells in Henoch-Schonlein purpura nephritis （HSPN） children. Methods According to their 24-hour urinary albumin and whether children with HSP had renal damage or not, 105 cases were divided into group A, B and C. Group A were children only with HSP but without renal damage, while group B were children only with HSPN not proteinuria and group C were children with both HSPN and proteinuria. Thirty healthy chil- dren were in healthy control group（ group N）. Flow cytometry （FCM） and real-time PCR detected the mRNA and pro- tein expressions of TLR3 and TLR4 in peripheral blood mononuclear ceils. Results 1. The mRNA and protein expres- sions of TLR4 in peripheral blood mononuclear cells were significantly higher in group A, B, C than those in group N （F =37.33,24. 01, all P 〈 0.05 ）. The mRNA and protein expressions of TLR4 in group C were much higher than those in group A and B （all P 〈 0.05 ）. Meanwhile, there was no significant difference between group A and B（ all P 〉 0.05 ）. 2. Moreover, there was a positive relationship between protein expression of TLR4 and 24-hour urinary albumin in group C （r = 0.69 ,P 〈 0.01 ）. 3. Expression of TLR3 was of no significant difference in all groups（ F = 0.86,1.78, all P 〉 0.05 ）. 4. The expression of TLR4 mRNA had a positive correlation with protein expression of TLR4 （r = 0.61, P 〈 0. 01 ）. Conclusions Expressions of TLR4 in peripheral blood mononuclear cells significantly increased and had a positive correlation with urinary protein excretion from HSPN in children. This implied that aberrant activation of TLR4 might be relevant to the development of HSPN.

关 键 词：过敏性紫癜 儿童 紫癜性肾炎 TOLL样受体 

分 类 号：R726.9[医药卫生—儿科]