CAJ | 학술논문

背景：Tol 样受体介导的信号通路转导及调节性T细胞异常活化在过敏性紫癜发病中的作用不清楚。 　　目的：研究Tol 样受体TLR2、TLR4、TLR6在过敏性紫癜患儿外周血单核细胞的表达及调节性T细胞(Treg)的免疫应答，探讨TLR及Treg活化在敏性紫癜发病机制中的作用。 　　方法：选择处于过敏性紫癜急性期的患儿42例为观察对象，另选取15名门诊健康查体儿童为正常对照组。采用流式细胞术检测外周血单核细胞的 TLR2、TLR4、TLR6的蛋白表达量；应用反转录-聚合酶链反应(RT-PCR)及实时荧光定量PCR检测外周血单核细胞TLR信号途径分子MyD88 mRNA的基因相对表达量；ELISA法测Treg细胞分泌的转化生长因子β、白细胞介素10的血浆水平；两组间比较采用独立样本t或t’检验，相关性分析采用Pearson相关检验。 　　结果与结论：过敏性紫癜患儿外周血单核细胞的TLR2、TLR4、TLR6蛋白的表达及MyD88 mRNA基因的相对表达量均显著高于对照组(P <0.01)；过敏性紫癜患儿血浆中转化生长因子β、白细胞介素10均高于对照组(P <0.05)；过敏性紫癜患儿TLR2、TLR4、TLR6的蛋白表达量与Myd88 mRNA的基因相对表达量呈正相关(P<0.01)，与血浆白细胞介素10、转化生长因子β水平无明显相关(P>0.05)。提示TLR2、TLR4、TLR6活化后可能通过MyD88依赖的途径参与敏性紫癜的发病，而过敏性紫癜急性期Treg代偿性活化可能为机体的保护性免疫应答。
배경：Tol 양수체개도적신호통로전도급조절성T세포이상활화재과민성자전발병중적작용불청초。 　　목적：연구Tol 양수체TLR2、TLR4、TLR6재과민성자전환인외주혈단핵세포적표체급조절성T세포(Treg)적면역응답，탐토TLR급Treg활화재민성자전발병궤제중적작용。 　　방법：선택처우과민성자전급성기적환인42례위관찰대상，령선취15명문진건강사체인동위정상대조조。채용류식세포술검측외주혈단핵세포적 TLR2、TLR4、TLR6적단백표체량；응용반전록-취합매련반응(RT-PCR)급실시형광정량PCR검측외주혈단핵세포TLR신호도경분자MyD88 mRNA적기인상대표체량；ELISA법측Treg세포분비적전화생장인자β、백세포개소10적혈장수평；량조간비교채용독립양본t혹t’검험，상관성분석채용Pearson상관검험。 　　결과여결론：과민성자전환인외주혈단핵세포적TLR2、TLR4、TLR6단백적표체급MyD88 mRNA기인적상대표체량균현저고우대조조(P <0.01)；과민성자전환인혈장중전화생장인자β、백세포개소10균고우대조조(P <0.05)；과민성자전환인TLR2、TLR4、TLR6적단백표체량여Myd88 mRNA적기인상대표체량정정상관(P<0.01)，여혈장백세포개소10、전화생장인자β수평무명현상관(P>0.05)。제시TLR2、TLR4、TLR6활화후가능통과MyD88의뢰적도경삼여민성자전적발병，이과민성자전급성기Treg대상성활화가능위궤체적보호성면역응답。
BACKGROUND:The influence of Tol-like receptor 2 (TLR2), Tol-like receptor 4 (TLR4), Tol-like receptor 6 (TLR6) signal transduction pathway and active Treg in children with Henoch-Schonlein purpura has been unknown. OBJECTIVE:To investigate the expression of TLR2, TLR4 and TLR6 in peripheral blood mononuclear cells and Treg immune response in patients with Henoch-Schonlein purpura, and to explore the role of TLR2, TLR4, TLR6 and Treg activation in the pathogenesis of Henoch-Schonlein purpura. METHODForty-two hospitalized children with Henoch-Schonlein purpura were enrol ed in this study. Another 15 healthy children were selected as controls. TLR2, TLR4 and TLR6 at protein level in peripheral blood mononuclear cells were detected by flow cytometey;reverse-transcription PCR and real-time PCR were used to evaluate the level of MyD88;the levels of transforming growth factor-βand interleukin-10 were measured by enzyme-linked immunosorbent assay. t-test or t’-test was used to compare the levels of these genes and proteins. Pearson’s correlation test was done for correlation analysis. RESULTS AND CONCLUSION:Compared with the control group, the protein levels of TLR2, TLR4, TLR6 and the relative expression level of MyD88 mRNA were significantly up-regulated (P<0.01). The serum levels of transforming growth factor-βand interleukin-10 were higher in the Henoch-Schonlein purpura children than the healthy children (P<0.05). There was a significant correlation between the protein levels of TLR2, TLR4, TLR6 and mRNA level of MyD88 (P<0.01), but no relationship was found between TLRs and interleukin-10, transforming growth factor-β(P>0.05). The excessive activation of TLR2, TLR4, TLR6 may be involved in the process of Henoch-Schonlein purpura via MyD88-dependent pathway, and the compensatory activation of Treg may participate in protective immunity.