The Analysis Of TLR4 Gene Polymorphism And Inflammatory Factor Expression In Peripheral Blood In Sepsis

Objective To investigate the polymorphism of TLR4, the expression of TLR4, IFN-γ, IL-23, PCT and CRP in peripheral blood of different phase of sepsis and health group. To study whether the expression of these inflammatory factors were correlated with the severity of sepsis and have sensitivity on the diagnosis of sepsis. This study will provide the theoretical basis in sepsis and new research ideas in the clinical diagnosis and treatment. Methods Total of 53 patients with sepsis and 47 healthy people were enrolled in this study, and their clinical general information were recorded including gender, age. The genome DNA in peripheral blood was extracted for detecting the gene polymorphism of TLR4.The expression of TLR4 mRNA in peripheral blood was detected by RT-PCR. The expression of IFN-γ, IL-23, PCT and CRP were detected by ELISA. Results The Asp299Gly site in sepsis do not exist polymorphism. The expression level of TLR4 mRNA in peripheral blood were compared among different groups and had significant differences with t=5.741 and 4.186 (sepsis group (APACHE Ⅱ≤20) VS normal group), t=14.78 and 13.83 (normal group VS sepsis group (APACHE Ⅱ>20)), t=10.50 and 9.645 (sepsis group (APACHE Ⅱ≤20) VS (APACHE Ⅱ> 20)), P< 0.01 for respectively at d1 and d7. TLR4 concentration was positively related with sepsis severity. The concentration of IFN-γ,IL-23,PCT,CRP in peripheral blood were significantly increased in sepsis at dl,d7. The concentration of IFN-γ,IL-23 were positively correlated with TLR4 concentration in early sepsis. The best cutoff value of TLR4 at baseline was 891.6 ng/ml, and 100% sensitivity,57% specificity. The best cutoff value of IFN-γ at baseline was 84.5 ng/ml, with a sensitivity of 100%, specificity of 57%. The best cutoff value of IL-23 at baseline was 861 ng/ml, with a sensitivity of 100%, specificity of 97%. The diagnostic rate of TLR4,IFN-γ and IL-23 appears high relative with the diagnosis of sepsis. Conclusion The Asp299Gly site in sepsis do not exist polymorphism. TLR4 concentration was positively related with sepsis severity. The concentration of IFN-y,IL-23 were significantly positive correlated with TLR4 concentration in early sepsis. TLR4,IFN-y and IL-23 might be used as a biomarker for early diagnosis of sepsis.