小儿肺炎支原体肺炎TLR4、NLRP3炎性小体表达及其与疾病进展的关系  

Expression of inflammasomes TLR4 and NLRP3 in children with Mycoplasma pneumoniae pneumonia and its association with disease progression

作　　者：奚玉秀[1] 陈晓宇[1] 崔盈[1] 过黎黎 沈峰 周春香[2] 张晓枫 XI Yu-xiu;CHEN Xiao-yu;CUI Ying;GUO Li-li;SHEN Feng;ZHOU Chun-xiang;ZHANG Xiao-feng(Affiliated Hospital of Jiangnan University,Wuci,Jiangsu 214122,China)

机构地区：[1]江南大学附属医院儿科,江苏无锡214122 [2]江南大学附属医院呼吸内一科,江苏无锡214122

出　　处：《中华医院感染学杂志》2023年第1期129-132,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金青年项目(81500071)。

摘　　要：目的 探究肺炎支原体肺炎(MPP)患儿外周血单个核细胞中Toll样受体-4(TLR4)、NOD样受体蛋白3(NLRP3)炎性小体表达及其与疾病进展的关系。方法 选取2017年1月-2021年4月于江南大学附属医院接受治疗的MPP患儿112例为研究组,根据其疾病严重程度分为轻症组67例和重症组45例,另选取健康体检儿童50名为对照组,采集入组研究对象外周静脉血,检测单个核细胞中TLR4和NLRP3相对表达量,检测血清炎症因子白细胞介素(IL)-1β、IL-18水平。结果 研究组TLR4、NLRP3 mRNA表达水平及IL-1β、IL-18水平均高于对照组(P<0.05);重症组MPP患儿外周血TLR4、NLRP3 mRNA表达水平和IL-1β、IL-18水平均高于轻症组(P<0.05);Pearson相关性分析表明,MPP患儿TLR4、NLRP3 mRNA表达水平与IL-1β、IL-18水平均呈正相关(P<0.05);受试者工作特征(ROC)曲线分析显示,TLR4、NLRP3 mRNA表达水平预测重症MPP的曲线下面积(AUC)为0.950、0.994。结论 MPP患儿TLR4、NLRP3 mRNA表达水平及IL-1β、IL-18水平均升高,且TLR4、NLRP3炎性小体可作为MPP病情进展的预测因子。OBJECTIVE To explore the expression of inflammasomes Toll-like receptor 4(TLR4) and NOD-like receptor protein 3(NLRP3) in peripheral blood mononuclear cells(PBMCs) of children with Mycoplasma pneumoniae pneumonia(MPP) and analyze its association with disease progression. METHODS A total of 112 children with MPP who were treated in the Affiliated Hospital of Jiangnan University from Jan 2017 to Apr 2021 were assigned as the study group and divided into the mild group with 67 cases and the severe group with 45 cases according to the severity of disease, meanwhile, 50 healthy children who received physical examination were chosen as the control group. The peripheral blood specimens were collected from the enrolled research subjects, the relative expression levels of TLR4 and NLRP3 in PBMCs were detected, and the levels of serum inflammatory factors interleukin(IL)-1β and IL-18 were detected. RESULTS The expression levels of TLR4, NLRP3 mRNA and levels of IL-1β and IL-18 were higher in the study group than in the control group(P<0.05). The expression levels of peripheral blood TLR4, NLRP3 mRNA and levels of IL-1β and IL-18 were higher in the severe group than in the mild group(P<0.05). Pearson correlation analysis indicated that the expression levels of TLR4 and NLRP3 mRNA of the children with MPP were positively correlated with the levels of IL-1β and IL-18(P<0.05). Receiver operating characteristic(ROC) curve analysis showed that the areas under curves(AUCs) of TLR4 and NLRP3 mRNA were respectively 0.950 and 0.994 in prediction of severe MPP. CONCLUSION The children with MPP show the rise of expression levels of TLR4, NLRP3 mRNA as well as the levels of IL-1β and IL-18. The inflammasomes TLR4 and NLRP3 can be used as factors for prediction of progression of MPP.

关 键 词：肺炎支原体肺炎 儿童 TOLL样受体-4 NOD样受体蛋白3 疾病进展 

分 类 号：R725.6[医药卫生—儿科]