The Research Of Clinical Significance For Expression Of TLR4 And IFN-γ On RSV Pneumonia Children

Object: First,to observe the expression of TLR4 on monocytes in peripheral blood after RSV infection and the relationship between TLR4 expression and disease severity or atopic disposition;Second,to evaluate the relationship between IFN-γconcentration and disease severity or atopic disposition in acute infection phase.To discuss the pathogenesis of RSV infection.Method: groups:1. test group:30 children who got phneumonia.Through the disease symptom and physical examination,we devide the group into two groups:22 children are the mild and moderate ones,8 children are severe ones.On the basis of atopy(eczema ,for example) and family history(asthma,allergic rhinitis,allergic conjunctivitis ,atopic dermatitis and so on),we devide the group into two groups:one group with atopic disposition concludes 19 children and the other without atopic disposition concludes 11 children.2.control group : 27 children admitted into hospital for surgical reasons without respiratoty infection in the last week. laboratory examination:The RSV was examined by indirect immunofluorescence.The expression of TLR4 was analyzed by flow cytometry .The concentration of IFN-γwas assayed by ELISA.Results:1.The expression of TLR4 in test group is 22.02±23.66%,and in control group is 12.67±11.59%,there is statistical significance(P=0.001<0.05) by U test.TLR4 in mild group of test group is 21.44±16.33%,while in sever group is 24.61±17.28%,there is no statistical significance(P=0.872>0.05).TLR4 in test group with atopic disposition is 21.99±16.14%,and in group without atopic disposition is 22.79±17.48%,there is no statistical significance(P = 0.966>0.05).These results indicate that RSV infection up-regulates the expression of TLR4 on monocyte in peripheral blood which was not relevant to disease severity, and there are no relationship between TLR4 and atopic disposition.2.The median concentration of IFN-γin test group is 12.565ng/L ,and in control group is 9.59ng/L ,and between the two groups there is no statistical significance(P=0.64>0.05).The median concentration of IFN-γin mild group of test group is 26.425 ng/L ,while in severe group is 0ng/L , obviously there is statistical significance(P=0.045<0.05). The median concentration of IFN-γin test group with atopic disposition is 53.61ng/L ,and in test group without atopic disposition is 11.08 ng/L ,and there is no statistical significance(P=0.25>0.05).These results suggest that concentration of IFN-γ,which is not inflenced by atopic disposition,in test group is not different from that in control group,but it has a negative relation with disease severity that the mild subjects have high concentration and the severe subjects have low concentration.Conclusion: 1.The expression of TLR4 on peripheral blood monocyte up-regulates during acute RSV infection.But the expression of TLR4 does not obviously relate to the severity of disease,and is not influenced by atopic disposition during acute RSV infection.2.The concentration of IFN-γof test group is not significantly different from that of control group. The concentration of IFN-γnegatively relates to disease severity ,that the concentration of severe children is lower than that of mild children.It is rational to use IFN-γfor severe RSV pneumonia children.During RSV infection,the concentration of IFN-γhas not distinct relation with atopic disposition.