The Expression Of Gene And Proteins Of CD14 And TLR4 On The Peripheral Blood Monocytes In Patients With Severe Chronic Hepatitis B

Objective To explore the effect of CD14 and TLR4 on the mechanism of intestinal endotoxemia in chronic severe hepatitis.Methods The expression of membrane CD14,CD14 mRNA and TLR4 mRNA in the peripheral blood monocytes (PBMs) from 30 cases of chronic severe hepatitis patients,20 cases of chronic hepatitis B patients and 10 cases of healthy controls were detected by flow cytometry and reverse transcription-polymerase reaction (RT-PCR) methods. Moreover, the level of plasma endotoxin and serum sCD14 were assayed by limulus amebocyte lysate test and ELISA respectively. Results The expression of CD14 mRNA and TLR4 mRNA in peripheral blood mononuclear cells (PBMCs) were significantly higher in chronic severe hepatitis patients(2.65±0.47 and 1.36±0.25, respectively)than those in healthy controls (0.96±0.35 and 0.64±0.12, respectively p<0.01) and in chronic hepatitis patients (1.24±0.31 and 0.81±0.16 , respectively p<0.01 ). The level of plasma endotoxin and serum sCD14 was also remarkably higher in chronic severe hepatitis patients (0.651±0.548 and 6.736±3.018, respectively ) than those in healthy controls (0.0246 ±0.0279 and 2.447±1.281, respectively P<0.01) and in chronic hepatitis patients (0.0531±0.0483 and 3.215±1.654, respectively P<0.01). But there was no significantly difference on the level of mCD14 among three groups. Furthermore, correlation analysis showed that there was positive correlation between the level of plasma endotoxin and the expression of sCD14(r1=0.612,P<0.05),CD14 mRNA (r2=0.415, P<0.05),TLR4 mRNA (r3=0.524,P<0.05). Conclusion endotoxemia is of important effect during the occurrence and development of chronic severe hepatitis. Intestinal endotoxin probably activates mononuclear phagocyte system by CD14／TLR4 compound receptors pathway, which ultimately induces liver failure. There is functionally synergic relation between sCD14 and mCD14.