Toll - Like Receptors In The Neonatal Surgical Stress Research

Objective:Toll-like receptor which recognize microbial pathogens play a critical role in innate immunity, however, their expression and function after surgery remain unknown. The aim of this study was to examine TLR2 and TLR4 expression on monocytes in infants and neonates undergoing major surgery.Methods:The subjects were 30 neonates which were congenital disease. Samples of 2 ml peripheral blood were obtained and heparinized before operation, at the end of operation, and 1, 3days after operation. TLR2 and TLR4 expressions on CD14+cells (PBMCs) were analyzed by flow cytometry. Concentrations of IL-6 and TNFαin serum were measured with enzyme-linked immunosorbent assay.Results:1.Basic information:The total of 30 neonates had been successfully operatied. There is no significant difference of weight and age(P>0.05).2.Counting of WBC and PMN:After operation counting of WBC and PMN were lower, but there isn't significant difference (P>0.05), but the postoperative 1 days were returned to normal, and postoperative 3 days were heightened. (P<0.05).3.Expression of TLR2 and TLR4:A significantly decreased frequency of TLR2 and TLR4 in neonates were observed at the end of the operation(P<0.05). And then recoverd to the preoperative values on postoperative day 1(P>0.05). On postoperative 3 days the frequency of TLR2 and TLR4 were higher.4.Change of TNF-α,IL-6 level in serum:Neonatal postoperative TNF-α, IL-6 level does not change significantly(P>0.05).Postoperative 1 day it will begin to heighten, on postoperative 3 days the expression level were highest (P<0.05).Conclusion:The reduced expression of TLR2 and TLR4 and leukopenia which caused by surgical stress, can suppress immune responses and increase the risk of postoperative infection and mortality.