人鼻病毒感染喘息急性发作儿童外周血NLRP3和TLR4水平及临床意义  

Expression and clinical significance of NLRP3 and TLR4 in peripheral blood of children with acute wheezing caused by human rhinovirus

作　　者：雷丽莉 于晓峰[1] 王媛媛[1] 徐迎军[1] Lei Lili;Yu Xiaofeng;Wang Yuanyuan;Xu Yingjun(Department of Emergency,Qingdao Women and Children's Hospital,Qingdao 266034,Shandong Province,China)

机构地区：[1]青岛大学附属妇女儿童医院急诊科,青岛266034

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第4期440-445,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：山东省自然科学基金青年项目(ZR2020QH054)。

摘　　要：目的探讨3~8岁人鼻病毒(HRV)感染喘息急性发作儿童外周血NOD样受体蛋白(NLRP)3和Toll样受体(TLR)4水平及临床意义。方法选择2023年9月至2024年3月在青岛大学附属妇女儿童医院急诊科就诊因HRV感染所致首次喘息急性发作的126例3~8岁患儿为研究对象。根据病情程度,将其分为轻、中度组(n=80)和重度组(n=46)。采用独立样本t检验,对2组患儿年龄、体重、人体质量指数(BMI),外周血白细胞计数(WBC)、中性粒细胞计数(NEUT)、淋巴细胞计数(LY)、C反应蛋白(CRP)及白细胞介素(IL)-6、TLR4水平和NLRP3 m RNA相对表达水平等比较。采用χ2检验,对2组患儿性别构成比,湿疹史、父母变态反应史占比等进行比较。再采用Pearson相关性分析外周血IL-6、TLR4水平和NLRP3 m RNA相对表达水平与儿童喘息急性发作严重程度的相关性。本研究遵循的伦理学原则获得医院伦理委员会的批准(审批文号:QFELL-KY-2020-23)。结果①2组患儿性别构成比、年龄、体重、BMI与湿疹史及父母变态反应史占比等一般临床资料比较,差异均无统计学意义(P>0.05)。②轻、中度组患儿外周血IL-6、TLR4水平和NLRP3 m RNA相对表达水平,均低于重度组,并且差异有统计学意义(P<0.05)。③HRV感染喘息急性发作儿童喘息严重程度与外周血IL-6、TLR4水平和NLRP3 m RNA相对表达水平分别呈正相关关系(r=0.772、0.792、0.897,P<0.001)。④外周血TLR4与NLRP3 m RNA亦呈正相关关系(r=0.820,P<0.001)。结论HRV感染致喘息急性发作儿童外周血NLRP3及TLR4水平,与其喘息严重程度密切相关。NLRP3可能通过诱导外周血IL-6分泌,上调TLR4介导HRV感染患儿气道高反应性(AHR),诱导喘息急性发作。Objective To evaluate the expression and clinical significance of NOD-like receptor protein 3(NLRP3)and Toll-like receptor 4(TLR4)in the peripheral blood of children with acute wheezing caused by human rhinovirus(HRV)infection.Methods From September 2023 to March 2024,a total of 126 children aged 3-8 who were admitted to Department of Emergency,Qingdao Women and Children's Hospital for the first time with acute wheezing due to HRV infection were selected into this study.According to the severity of the disease,they were divided into mild and moderate group(n=80)and severe group(n=46).The age,weight,body mass index(BMI),white blood count(WBC),neutrophil count(NEUT),lymphocyte count(LY),C reaction protein(CRP),interleukin(IL)-6,TLR4 and NLRP3 m RNA levels of the two groups were compared by independent samples t test.Chi-square test was used to compare the sex composition ratio,percentage of eczema history and parental allergy history between the two groups.Pearson correlation was used to analyze the correlation between IL-6,TLR4 and NLRP3 m RNA and the severity of acute wheezing attack in children.This study follows the ethical principles and was approved by the Hospital Ethics Committee(Approval No.QFELL-KY-2020-23).Results①There were no statistically significant differences in the gender composition ratio,age,weight,BMI,and the percentage of eczema history and parental allergy history between two groups(P>0.05).②The levels of IL-6,TLR4 and NLRP3 m RNA in the mild to moderate group were lower than those in the severe group(P<0.05).③The severity of wheezing in patients with acute wheezing caused by HRV was positively correlated with the levels of IL-6,TLR4 and NLRP3 m RNA(r=0.772,0.792,0.897,P<0.001).④There was a positive linear correlation between TLR4 and NLRP3 mRNA(r=0.820,P<0.001).Conclusions NLRP3 and TLR4 in peripheral blood of children with acute wheezing caused by HRV infection are closely related to the severity of wheezing.NLRP3 may mediate airway hyperresponsiveness in patients with HRV infection

关 键 词：人鼻病毒 喘息 NOD 样受体蛋白3 TOLL样受体4 儿童 

分 类 号：R725.6[医药卫生—儿科]