儿童肺炎支原体肺炎肺泡灌洗液CARDS TX、HMGB1、TLR2表达及临床意义  

Expression and clinical significance of CARDS TX, HMGB1 and TLR2 in bronchoalveolarlavage fluid in children with mycoplasma pneumoniae pneumonia

作　　者：李玉琴[1] 王喆[1] 丁莹[1] 储矗[1] 周卫芳[1] LI Yuqin;WANG Zhe;DING Ying;CHU Chu;ZHOU Weifang(Department of Infectious Diseases,Children's Hospital of Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州大学附属儿童医院感染性疾病科,江苏苏州215000

出　　处：《右江医学》2024年第5期399-404,共6页Chinese Youjiang Medical Journal

基　　金：2023年度苏州市临床重点病种诊疗技术专项拟定项目(LCZX202313)。

摘　　要：目的研究肺炎支原体肺炎(MPP)患儿肺泡灌洗液中社区获得性呼吸窘迫综合征毒素(CARDS TX)、高迁移率族蛋白1(HMGB1)、Toll样受体2(TLR2)表达,探讨其在MPP发病中的临床意义。方法回顾性分析55例MPP病例组及20例对照组临床资料,同时检测两组支气管肺泡灌洗液(BALF)中CARDS TX、HMGB1、TLR2、TLR4、晚期糖基化终末产物受体(RAGE)及髓样分化因子88(MyD88)表达,体外检测不同浓度CARDS TX刺激下HMGB1、TLR2的表达并进行比较。结果与对照组相比,MPP组LYM绝对值计数、PA、CD3^(+)、CD3^(+)CD4^(+)、CD3^(+)CD8^(+)、CD3-CD19^(+)、NK cell、CD19^(+)CD23^(+)明显下降,CRP、LDH、D-二聚体、IgA、IgG、IgM、CARDS TX、HMGB1、TLR2、MyD88均升高,差异有统计学意义(P<0.05或0.001)。CARDS TX刺激后HMGB1、TLR2的表达升高,且呈正相关,差异有统计学意义(P<0.001)。结论CARDS TX可能通过HMGB1-TLR2-MyD88途径参与肺炎支原体(MP)的致病。Objective To investigate the expressions of community-acquired respiratory distress syndrome toxin(CARDS TX),high mobility group box-1 protein(HMGB1)and Toll-like receptors 2(TLR2)in bronchoalveolar lavage fluid in children with mycoplasma pneumoniae pneumonia(MPP),and to explore the clinical significance of CARDS TX,HMGB1 and TLR2 in the pathogenesis of MPP.Methods Retrospective analysis was carried out on the clinical data of 55 MPP children and 20 children in control group.And the expressions of CARDS TX,HMGB1,TLR2,TLR4,receptor of advanced glycation endproducts(RAGE)and myeloid differentiation primary response 88(MyD88)in bronchoalveolar lavage fluid(BALF)of the two groups.In addition,the expressions of HMGB1 and TLR2 after stimulation with different concentrations of CARDS TX in vitro were detected and compared.Results Compared with the control group,LYM absolute value count,PA,CD3^(+),CD3^(+)CD4^(+),CD3^(+)CD8^(+),CD3-CD19^(+),NK cell,and CD19^(+)CD23^(+)were significantly decreased,while CRP,LDH,D-dimer,IgA,IgG,IgM,CARDS TX,HMGB1,TLR2 and MyD88 were significantly increased,and difference was statistically significant(P<0.05 or 0.001).The expression of HMGB1 and TLR2 increased after CARDS TX stimulation,there was a positive correlation between them,and difference was statistically significant(P<0.001).Conclusion CARDS TX may be involved in the pathogenesis of mycoplasma pneumoniae(MP)through HMGB1-TLR2-MyD88 pathway.

关 键 词：肺炎支原体肺炎 社区获得性呼吸窘迫综合征毒素 高迁移率族蛋白1 TOLL样受体2 髓样分化因子88 

分 类 号：R725.6[医药卫生—儿科]