CAJ | 학술논문

目的：探讨TLR6在过敏性紫癜（HSP）患儿外周血单个核细胞（PBMC）的表达及其与Th1、Th2和Th17细胞免疫应答的相关性，探讨TLR6与HSP发病机制的关系。方法选取我院住院的急性期HSP患儿42例为研究对象，另选取健康儿童30例作为正常对照组。采用流式细胞术检测外周血单个核细胞TLR6蛋白表达，实时荧光定量PCR技术检测外周血单个核细胞MyD88 mRNA的基因相对表达量，ELISA法检测血浆IFN-γ、IL-4、IL-17水平。结果（1）HSP患儿外周血单个核细胞TLR6蛋白表达（TLR6阳性细胞百分率及平均荧光强度）显著高于正常对照组（t'＝9.40， P＜0.01；t'＝10.49，P＜0.01），HSP组外周血单个核细胞MyD88 mRNA相对表达量显著明显高于正常对照组（t'＝2.46，P＜0.01）。（2）HSP组血浆IL-4水平显著高于对照组（t'＝3.44，P＜0.01），IFN-γ水平高于对照组（t'＝2.44，P＜0.05），IFN-γ/IL-4比值低于对照组（t'＝2.27，P＜0.05），IL-17水平显著高于对照组（t'＝2.64，P＜0.01）。（3）HSP组单个核细胞TLR6蛋白表达与MyD88 mRNA呈显著正相关（r＝0.79；P＜0.01）；与血浆IL-4水平呈显著正相关（r＝0.69，P＜0.01）；与IFN-γ/IL-4比值呈负相关（r＝-0.38，P＜0.05）；与IL-17水平呈正相关（r＝0.36，P＜0.05）；与血浆IFN-γ水平不存在相关性（P＞0.05）。结论 TLR6活化可能参与了HSP的免疫发病机制；HSP患儿体内存在Th1/Th2失衡，Th17异常活化，活化的TLR6可能通过上调Th2、Th17免疫应答介导HSP的免疫发病机制。
목적：탐토TLR6재과민성자전（HSP）환인외주혈단개핵세포（PBMC）적표체급기여Th1、Th2화Th17세포면역응답적상관성，탐토TLR6여HSP발병궤제적관계。방법선취아원주원적급성기HSP환인42례위연구대상，령선취건강인동30례작위정상대조조。채용류식세포술검측외주혈단개핵세포TLR6단백표체，실시형광정량PCR기술검측외주혈단개핵세포MyD88 mRNA적기인상대표체량，ELISA법검측혈장IFN-γ、IL-4、IL-17수평。결과（1）HSP환인외주혈단개핵세포TLR6단백표체（TLR6양성세포백분솔급평균형광강도）현저고우정상대조조（t'＝9.40， P＜0.01；t'＝10.49，P＜0.01），HSP조외주혈단개핵세포MyD88 mRNA상대표체량현저명현고우정상대조조（t'＝2.46，P＜0.01）。（2）HSP조혈장IL-4수평현저고우대조조（t'＝3.44，P＜0.01），IFN-γ수평고우대조조（t'＝2.44，P＜0.05），IFN-γ/IL-4비치저우대조조（t'＝2.27，P＜0.05），IL-17수평현저고우대조조（t'＝2.64，P＜0.01）。（3）HSP조단개핵세포TLR6단백표체여MyD88 mRNA정현저정상관（r＝0.79；P＜0.01）；여혈장IL-4수평정현저정상관（r＝0.69，P＜0.01）；여IFN-γ/IL-4비치정부상관（r＝-0.38，P＜0.05）；여IL-17수평정정상관（r＝0.36，P＜0.05）；여혈장IFN-γ수평불존재상관성（P＞0.05）。결론 TLR6활화가능삼여료HSP적면역발병궤제；HSP환인체내존재Th1/Th2실형，Th17이상활화，활화적TLR6가능통과상조Th2、Th17면역응답개도HSP적면역발병궤제。
Objective To investigate the expression of TLR6 in peripheral blood mononuclear cells and its correlation with Th1, Th2 and Th17 immune response in children with Henoch-Schonlein purpura(HSP), to explore the relationship between Toll-like receptor 6 and the pathogenesis of HSP. Methods Forty-two patients with HSP and 30 age-matched healthy subjects were recruited. Flow cytometry (FCM) was performed to detect the expression of TLR6. The relative expression level of MyD88 mRNA in PBMCs was detected by real-time fluorescent PCR. The levels of IFN-γ, IL-4 and IL-17 in plasma were determined by ELISA. Results (1)The levels of TLR6 and MyD88 mRNA of the HSP children were significantly higher than the control group (P<0.01). (2)The levels of IL-4, IFN-γand IL-17 in plasma of HSP children were significantly higher than the controls (t'=3.44, P<0.01; t'=2.44, P<0.05;t'=2.64, P<0.01), and the ratio of IFN-γ/IL-4 in plasma of HSP children was lower than the control group (t'=2.27, P<0.05). (3)The mRNA expression of MyD88 showed a positive correlation with expression of Toll-like receptor 6 protein of CD4+T in HSP children (r=0.79; P<0.01); Toll-like receptor 6 had positively correlated with IL-4 (r=0.69, P<0.01); and negatively correlated with the ratio of IFN-γ/IL-4 ratio (r=-0.38, P<0.05); and positively associated with IL-17 (r=0.36, P<0.05); had no correlation with plasma IFN-γ (P>0.05). Conclusion The aberrant activation of TLR6 might be associated with the immunological pathogenesis of HSP by enhancing Th17 immune response. The hyper-activation of Th2 and Th17 might be involved in the process of HSP development.