Expressions And Significances Of TLR2,4and9in Peripheral Blood Mononuclear Cells And Bone Marrow Mononuclear Cells In Patients With SLE

Objective:To exam the expression rate and intensity of TLR2,4and9in peripheral blood mononuclear cells and bone marrow mononuclear cells and serum levels of IL-6, IL-10and TNF-a in patients with systemic lupus erythematosus (SLE), in order to know the different expression level of TLR2,4and9in peripheral blood mononuclear cells and bone marrow mononuclear cells in different stages and concomitant infection condition of SLE, analyse the relativity between TLRs, IL-6, IL-10,TNF-a levels and disease activity and concomitant infection, discuss their significances in the pathogenesis of SLE. This study will lay the foundations for the intensive research of the treatment of SLE.Methods:148cases of SLE (17cases were male and131were female) and40age and sexuality-matched normal subjects were collected. The patients were divided into activity group (56cases), stable group (47cases) and infection group (45cases) according to SLEDAI score. The expression rates of TLR2,4and9in peripheral blood mononuclear cells were examed by flow cytometry. The actual expression levels of TLR2,4and9in peripheral blood mononuclear cells were analyzed by Fluorescence Quantitative PCR in20subjects randomly selected from each groups. Then the expression rates of TLR2,4and9in bone marrow mononuclear cells in SLE groups (20subjects randomly selected from each groups) were examed by flow cytometry and compared with the rates in peripheral blood. Serum levels of IL-6, IL-10and TNF-a in SLE groups were tested by ELISA assay, and their relevency with SLE active level, concomitant infection condition, TLRs expression in peripheral blood were analysed.Results:The expression rates of TLR2,4and9in peripheral blood mononuclear cells were increased in SLE groups than normal control group (P<0.05). The highest expression levels of TLR2and4were in the infection group, for TLR9was in the activity group. TLR2and4expressions were positive correlated with CRP and negative correlated with IgG (P<0.05). TLR9was positive correlated with SLEDAI score in active period of SLE (P<0.05). The actual expression levels of TLR2,4and9in peripheral blood were increased in SLE patients than normal control group (P<0.05). The highest expression levels of TLR2and4were in the infection group, for TLR9was in the activity group. The expression rates of TLR2(P<0.05) and TLR4(P<0.01) in bone marrow mononuclear cells in infection group were higher than stable group. TLR2and9expressions in peripheral blood mononuclear cells were higher than in bone marrow (P<0.05). IL-6levels in activity group and stable group were higher than normal control group (P<0.05), the highest level was in the activity group. IL-6levels in activity group were positive correlated with urine protein, dsDNA level and SLEDAI score, and were related to TLR2and4. IL-10levels in SLE groups were all higher than normal control group (P<0.05), the highest level was in the activity group. IL-10levels in activity group were positive correlated with CRP, dsDNA level, SLEDAI score, and were related to TLR4. TNF-a levels in activity group and infection group were higher than normal control group (p<0.05), the highest level was in the activity group. TNF-a levels were positive correlated with SLEDAI score, negative correlated with plasma albumin, and were related to TLR4and9.Conclusions:TLR2,4and9, which were inceased in peripheral blood mononuclear cells in patients with SLE, played an important role in the occurrence and development of SLE. TLR2and4were closely related with the concomitant infection, TLR9played a dominant role in disease activity regulation. TLR2,4and9were inceased in bone marrow mononuclear cells in SLE patients, marrow-derived cells also had immunoregulatory activity and were related with the occurrence of SLE and concomitant infection. IL-6, IL-10and TNF-a levels were all increased in SLE patients and were bound up with active level and TLRs expression.