Study On The Expression Of TLR4in Peripheral Blood Mononuclear Cell Of Patients With Chronic Kidney Disease

Objective：Detection of chronic kidney disease (CKD) in different periods in patientswith peripheral CD14-positive mononuclear cell surface expression of TLR4protein，and TNF-a, IL-6expression after LPS stimulation of inflammatorycytokines. We grouped divided into of CKD3, CKD4period, CKD5of healthycontrols. We also explore the significance and mechanisms of the peripheralCD14-positive monocyte TLR4protein expression in the progression ofchronic kidney disease, to provide a theoretical basis for clinical diagnosis andtreatment of chronic kidney disease and its complications.Method：In this study, we used flow cytometry to detect peripheral CD14-positivemonocyte surface TLR4protein expression and LPS stimulation of CD14positive monocytes cytokine TNF-a, IL-6secretion in nine cases CKD3ofpatients,11casesof CKD4patients,16cases CKD5patients and19healthycontrols. The same time, we examined the indicators of renal function (serumcreatinine, blood urea nitrogen)， blood, serum albumin, erythrocytesedimentation rate, C-reactive protein，and analysised TLR4expression incorrelation with the clinical indicators and TNF-a, IL-6.Result：（1）The CKD3group, CKD4group and CKD5group of patients withperipheral CD14+mononuclear cell surface expression of TLR4protein tendedto decrease than normal. CKD4and CKD5group were significantly lower thanthe normal control group except CKD3group. (2) CKD patients with peripheral CD14+mononuclear cell surfaceexpression of TLR4protein with CKD progress gradually reduced, the CKD3group> CKD4group> CKD5group. The CKD3group, the CKD4group andCKD5groups of TLR4-positive rate was4.87±1.98(%),3.64±0.49(%)1.90±0.40(%), and the difference was significant.(3) CKD group LPS-stimulated peripheral blood CD14+monocytes TNF-α,IL-6secretion is lower than the normal control group. The remaining of TNF-αand the normal control group were statistically significant differences （P<0.01）except CKD3group.(4) With CKD progress, the peripheral CD14+monocytes, TNF-α, IL-6secretion showed a trend to decrease, that is CKD3>CKD4> CKD5.Thedifference was statistically significant (P<0.05).(5) Peripheral CD14+mononuclear cell surface TLR4protein expressionlevels of eGFR, serum albumin, HCT，TNF-a, IL-6showed a significantpositive correlation（r=0.744, r=0.643，r=0.569，r=0.534，r=0.776，P<0.001）,And serum creatinine, blood urea nitrogen, c-reactive protein was significantlynegatively correlated r=-0.752，r=-0.661，r=-0.435，P<0.001）.Conclusion：1. Chronic kidney disease patients peripheral CD14+mononuclear cellsurface expression of TLR4protein decreased with CKD progression, andCKD5group in TLR4protein expression levels were significantly lower thanthe other groups.2. LPS can cause monocytes to produce TNF-α, IL-6and otherinflammatory factors, and along with the progress of CKD by the reducedinflammatory cytokines in monocytes after LPS stimulation.3. Chronic kidney disease innate immune receptor TLR4expressioncorrelated with TNF-α, IL-6secretion significantly positively. Reducedexpression of TLR4may cause of inflammatory cytokines IL-6and TNF-a reduced.