Expression and significance of toll-like receptor 2, 4 of peripheral blood mononuclear cells in acute abdomen patients associated with systemic inflammatory response syndrome

Abstract

The changes of Toll-like receptor (TLR) 2, 4 of peripheral blood mononuclear cells (PBMCs) in the acute abdomen patients associated with systemic inflammatory response syndrome (SIRS) and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-α and IL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group (P<0.01). TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-α could be detected with low value in normal controls, but they were up-regulated markedly on the 1st day after admission. Then TLR4 mRNA, IL-6 and TNF-α were decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group (P<0.01). The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-α and IL-6, and the hospital stay. The results of Logistic regression demonstrated that over-expression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome (MODS). It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.

Keywords

Toll-like receptor / acute abdomen / systemic inflammatory response syndrome

References

[1] BoneR. C. m., FeinA. M., BalkR. A., et al.. The ACCP/SCCM consensus conference committee: ACCP/SCCM consensus conference: definition for sepsis and organ failure and guide lines for the use of innovative therapies in sepsis. Chest, 1992, 101: 1644

[2] LiangL. J.. ZaideW., ZhaohanW.. Multiple organ dysfunction syndrome. Surgery(Chinese), 20036th ed.Beijing, People Public Health Publishing House: 55-58

[3] GuhaM., MackmanN.. LPS induction of gene expression in human monocytes. Cell Signal, 2001, 13: 85-94

[4] PinskyM. R., VincentJ. L., DeviereJ.. Serum cytokine levels in human septic shock: Relationship with multiple system organ failure and mortality. Chest, 1993, 103: 565-575

[5] TraceyK. J., BeutlerB., LowryS. F., et al.. Shock and tissue injury induced by recombinant human cachectin. Science, 1986, 234: 470-474

[6] TipayaratnM., TetsuyaM., TakeshiK., et al.. NF-κB and STATS play important roles in the regulation of mouse Toll-like receptor 2 gene expression. J Immuno, 2001, 166: 4516-4524