TLR4/MyD88/NF-κB信号通路在萎缩性胃炎伴幽门螺杆菌感染中的作用  

Role of TLR4 / MyD88 / NF signaling pathway in atrophic gastritis with Helicobacter pylori infection

作　　者：王艳[1] 毕亭亭 杨燕[1] 张海燕[1] 侯思慧 WANG Yan;BI Ting-ting;YANG Yan;ZHANG Hai-yan;HOU Si-hui(Xuzhou Central Hospital,Xuzhou,Jiangsu221000,China)

机构地区：[1]徐州市中心医院消化内科,江苏徐州221000

出　　处：《中华医院感染学杂志》2022年第8期1149-1152,共4页Chinese Journal of Nosocomiology

基　　金：江苏省医药卫生科技计划基金资助项目(201909663)。

摘　　要：目的 探讨Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核因子κB(NF-κB)信号通路在萎缩性胃炎伴幽门螺杆菌感染中的作用及临床意义。方法 选取2019年6月-2021年5月在徐州市中心医院消化内科接受治疗的118例萎缩性胃炎伴幽门螺杆菌感染患者作为胃炎组,根据慢性胃炎的内镜分型分级标准中的萎缩性胃炎分类标准分为Ⅰ级、Ⅱ级、Ⅲ级,同时选择40名健康人作为对照组。酶联免疫吸附法检测两组血清中TLR4、MyD88、NF-κB以及白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)炎性因子的表达水平。应用受试者工作特征曲线(ROC曲线)分析TLR4、MyD88和NF-κB对萎缩性胃炎伴幽门螺杆菌感染的预测价值。结果 与对照组比较,研究组患者TLR4、MyD88及NF-κB的表达量均增高(P<0.05);炎性因子IL-1β、IL-6、TNF-α的表达水平高于对照组(P<0.05);血清TLR4、MyD88和NF-κB联合预测萎缩性胃炎伴幽门螺杆菌感染的AUC为0.897,高于单独检测的0.854、0.858、0.870。结论 血清中TLR4、MyD88、NF-κB以及三个指标联合应用对萎缩性胃炎伴幽门螺杆菌感染的诊断具有较高的价值,推测通过调控TLR4/MyD88/NF-κB信号转导,降低炎症反应,进而控制萎缩性胃炎伴幽门螺杆菌感染的进程。OBJECTIVE To investigate the role and clinical significance of toll like receptor 4(TLR4)/myeloid differentiation factor 88(MyD88)/nuclear factor κB(NF-κB) signal pathway in the atrophic gastritis patients with Helicobacter pylori infection. METHODS Total of 118 atrophic gastritis patients with H. pylori infection treated in the Department of Gastroenterology of Xuzhou Central Hospital from Jun 2019 to May 2021 were recruited. According to the atrophic gastritis classification standard, the severity of chronic gastritis were divided into grade Ⅰ, grade Ⅱ and grade Ⅲ. Meanwhile, 40 healthy people were chosen as the control group. The serum TLR4, MyD88 and NF-κB, interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) levels were detected by enzyme linked immunosorbent assay. The receiver operating characteristic(ROC) curves were used to analyze the predictive value of TLR4, MyD88 and NF-κB in the diagnosis of H. pylori infection in atrophic gastritis patients. RESULTS Compared with the control group, the expression of TLR4, MyD88 and NF-κB in the study group were significantly higher(P<0.05);The expression levels of inflammatory factors including IL-1 β, IL-6 and TNF-α were also significantly higher than thoes in the control group(P<0.05). The AUC of the combined indexes of serum TLR4, MyD88 and NF in the prediction of H. pylori infection was 0.897, which was significantly higher than that of indexes individually, which were 0.854, 0.858 and 0.870, respectively. CONCLUSION The application of TLR4, MyD88, NF-κB and three indexes combined have high value in the diagnosis of atrophic gastritis complicated with H. pylori infection. It is speculated that the regulation of TLR4/MyD88/NF-κB signal transduction pathway can inhibit the process of atrophic gastritis with H. pylori infection by reducing inflammatory response.

关 键 词：TOLL样受体4 髓样分化因子88 核因子ΚB 幽门螺杆菌 萎缩性胃炎 

分 类 号：R573.3[医药卫生—消化系统]