Clinical Significance And Detection Peripheral Blood Mononuclear Cell Expression Of CD14, TLR4 And TLR2 In Cirrhosis With Ascites

AIM:○1 .To explore the correlation of Toll-like receptor 4, Toll-like receptor 2 expression on the surface of peripheral blood mononuclear cells with bacterial infection in patients with liver cirrhosis, and observe the effect of antibiotics on PBMC expression of TLR4 and TLR2 in cirrhosis.○2 . To explore the relationship of CD14 and bacterial infection in cirrhosis, PBMC expression of CD14, TLR4 and TLR2 in cirrhosis was analyzed respectively.○3 To observe the correlation on PBMC expression of CD14 and TLR4, TLR2 in cirrhosis.Methods: Blood cells from a total of 42 cirrhotic patients (30 with ascites, 12 without ascites ) and 15 normal controls were stained with fluorescent labeling anti-TLR2, anti-TLR4, anti-CD14 monoclonal antibodies. Samples were collected and analyzed for three-color immunofluorescence by flow cytometry.Result:○1 The expression of TLR4 and TLR2 were significantly higher in cirrhotic patients with ascites than those in the controls (TLR4: 22.28±0.80 vs 14.45±3.23, P<0.05; TLR2: 47.65±0.75 vs 24.40±2.77, P<0.05), and the difference also existed before and after treatment in the patients with cirrhosis and ascites(TLR4: 28.58±0.79 vs 12.37±0.35, P<0.05; TLR2 : 47.79±0.76 vs 17.22±2.48, P<0.05). TLR4 and TLR2 expression were notably increased in patients with ascites as compared with those in ones without ascites(TLR2:25.37±1.62;TLR4:14.81±0.29)(P<0.05),and they were not significantly different between patients without ascites and normal controls (P>0.05).○2 Differences of CD14 between cirrhotic patients with ascites group and normal controls group were obvious(P<0.05) . Differences of CD14 between cirrhotic patients with ascites group and cirrhotic patients without ascites group were obvious(P<0.05). Differences of CD14 between normal controls group and cirrhotic patients without ascites group were not obvious(P>0.05). Correlation of CD14 and TLR2 is significant at the 0.01 level (2-tailed), and correlation of CD14 and TLR4 is significant at the 0.05 level (2-tailed) in the patients with cirrohsis and ascites .Conclusion:○1 . PBMC expression of TLR4 and TLR2 are up-regulated in patients with liver cirrhosis, and they can be down-regulated by antibiotics treatment.○2 .Up-regulation of PBMC expression of CD14 occurs in cirrhosis. We assumed that up-regulated expression of CD14, TLR2 and TLR4 on PBMC implies a marked inflammatory response to bacterial pathogen in the patients with cirrhosis and ascites.