ILT4促进脓毒症炎性反应并介导免疫麻痹  

Immunoglobulin-like transcript-4 （ILT4） expression in mononuclear cells on the prognosis of sepsis

作　　者：章德文 丁娴 刘树雄 夏新宇 朱守朝 何建 

机构地区：[1]东方肝胆外科医院急诊科(第二军医大学第三附属医院),上海201805

出　　处：《中华急诊医学杂志》2017年第10期1160-1163,共4页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（81272138）;上海市卫计委课题（20124349）

摘　　要：目的：探讨脓毒症单核细胞表达ILT4的生物学行为和效应，及对于预后的影响。方法：选取BALB/c、BALB/c ILT4–/–雄性小鼠，CLP复制脓毒症模型。用流式细胞仪定量检测CLP术后24h单核细胞ILT4、MHC-Ⅱ表达水平；用ELISA法检测各组0、6、12、24h血清IL-6、TNF-α浓度；并观察168h内生存预后。 结果：CLP术后24小时脓毒症小鼠外周单核细胞高度表达ILT4分子 （193.50 ± 52.54 vs. 1292.00 ± 143.70, p 〈 0.05） ；较WT组ILT4–/–小鼠外周单核细胞表达MHC-Ⅱ比率明显增高（24.25± 6.76% vs. 49.38 ±5.66%, p 〈 0.05） 。CLP术后24h血清IL-6显著增高（54.25± 20.04 vs. 470.75±88.03, p 〈 0.05），ILT4敲除后很大程度的抑制这一趋势（470.75±88.03 vs. 241.25 ± 45.10, p 〈 0.05）；但对TNF-α表达无显著性干扰（53.13 ±5.49 vs. 50.88 ±6.38, p〉 0.05）。且ILT4–/–小鼠CLP术后生存率WT明显增加（p 〈 0.05）。结论：脓毒症时单核细胞高表达ILT4，与高IL-6水平及低MHC-Ⅱ表达率相关，导致死亡率增加。Objective To study the biological behaviors and effects of immunoglobulin-like transcript-4 （ILT4） expression in monormclear cells on the prognosis of sepsis. Methods ILT4 ＋/＋ （WT） and ILT4-knockout mice （ILT4-/-） male BALB/c mice were used for sepsis modeling using cecal ligation puncture （CLP）. Flow cytometry was used to measure the levels of expression of ILT4 and major histocompatibility complex class Ⅱ molecules （ MHC-Ⅱ ） in mononuclear cells of peripheral blood 24 h after CLP. ELISA was used to measure the concentrations of intedeukin-6 （IL-6） and serum tumor necrosis factor-alpha （TNF-α） in different groups of mice at 0 h, 6 h, 12 h, and 24 h after CLP to monitor the survival and prognosis over the course of 168 h. Results ILT4 was highly expressed in mononuclear cells of the peripheral blood of septic mice 24 h after CLP in comparison with that before CLP （1292.00±143.70） vs. （ 193.50±52. 54） , P 〈 0.05. MHC- Ⅱ expression in mononuelear cells of the peripheral blood in ILT4-/- mice was significantly higher than that in WT mice （49.38±5.66）% vs. （24.25±6.76） % , P 〈 0. 05 ）. Serum IL-6 was significantly elevated 24 h after CLP compared with that before CLP （470. 75±88.03） vs. （54. 25±20.04）, P 〈 0. 05. The serum IL-6 concentration was much lower in ILT4-/- mice than that in MT mice （241.25±45.10） vs. （470.75±88.03）, P 〈 0.05; whereas, there was no significant difference in TNF-ct expression between two groups of mice （50. 88±6. 38 ） vs. （53.13±5.49）, P 〉 0. 05. The survival rate of ILT4-/- mice was significantly higher after CLP compared with WT mice （P 〈 0. 05 ）. Conclusion The high level of ILT4 expression in mononuclear cells were observed in peripheral blood during sepsis and it was found to be associated with high serum IL-6 levels and low MHC-Ⅱ expression in mononuclear cells, leading to increased mortality.

关 键 词：脓毒症 单核细胞ILT4 CD85 MHC-Ⅱ IL-6 TNF—α 免疫麻痹 盲肠结扎穿孔术 

分 类 号：R459.7[医药卫生—急诊医学]