The Research On The Correlation Between The Expression Of TLR2,TLR4,PTX3 In Peripheral Blood And Preterm Birth

Objective This study examined the expression level of Toll- like receptors(TLR2, TLR4) and serum Pentraxin-3(PTX3) on the CD14+ cell surface in the peripheral blood mononuclear cells(PBMC), to explore the relevance between TLR2, TLR4, PTX3 and preterm birth and to investigate their predictive values in early diagnosis of preterm birth.Methods: 1. Eighteen patients with threatened preterm birth were enrolled as threatened preterm birth group while 37 pregnant women(28-36+6 weeks) who underwent prenatal examination regularly in the clinic were selected as control group. The patients in the threatened preterm birth group were admitted to hospital. Meanwhile, the blood samples of control group were extracted and processed when they underwent prenatal examination. The blood samples of these patients were collected before using any medications(e.g. contraction inhibited drugs, anti- infection drugs and fetal lung maturity medications). The expression of TLR2 and TLR4 on the of C D14+ cell surface in the PBMC was detected by Flow Cytometry(FCM) and the concentration of serum PTX3 was detected by Enzyme-linked Immunosorbent Assay(ELISA). All maternal age and gestational weeks were recorded simultaneously.2. As mentioned above, 55 pregnant women in total were followed up until their delivery. According to the pregnancy outcomes, these women were then divided into three groups: preterm delivery(treated) group(12 cases), term delivery(treated) group(6 cases) and normal term delivery group(30 cases). The expressions level of TLR2, TLR4 and PTX3 of these three groups at the same gestation were compared. 3. All experimental data were analyzed by SPSS17.0. P<0.05 was considered as statistically significant.Results: 1. Maternal age and gestational weeks between threatened preterm birth group and control group were both no significant difference(P>0.05). The results showed the two groups were comparable. 2. Compared with control group, the expression level of PTX3 and the expression rate of TLR2 on the CD14+ cell surface in the threatened preterm birth group were significant higher(P<0.05). There was no statistic difference of the expression of TLR4 between the two groups(P>0.05). 3. Compared with term delivery(treated) group, the concentration of serum PTX3 and the expression rate of the TLR2 on the CD14+ cell surface in the preterm delivery(treated) group were significant difference(P<0.05). However, there was no statistical significance(P>0.05) between these two groups on the expression rate of TLR4 during the same pregnant phases. Compared with the normal term delivery group, the concentration of serum PTX3 and the expression rate of the TLR2 and TLR4 on the CD14+ cell surface in the term delivery(treated) group showed no significantdifference(P>0.05) during the same pregnant phases. 4. There was no significant correlation between the expression rate of TLR2 on the CD14+ cell surface and the concentration of PTX3 in the threatened preterm birth group(r=0.254, P>0.05). Similarly, there was also no significant correlation between these two indicators in the preterm delivery(treated) group(r=0.337, P>0.05).Conclusion 1. When the clinical symptoms occurred, the expression levels of PTX3 and TLR2 in the threatened preterm birth group were higher than those in control group at the same pregnant age. It suggested that these indicators play an important role in the occurrence and progression of preterm birth. 2. Compared with the normal term delivery group, the expression level of PTX3 and TLR2 in the PBMC of the preterm delivery(treated) group were significantly higher, while that of the term delivery(treated) group had no significant difference. These finding suggested that TLR2, TLR4 and PTX3 were promising biomarkers, which not only could reflect the level of inflammatory response but also have the possibility to become preterm labor sensitive indicators. Combined with preterm labor clinical symptoms, these indicators provide a more effective vision for predicting the occurrence of preterm birth. 3. There was no statistic difference of the expression of TLR4 between the threatened preterm birth group and control group. Other researches, however, have found a significant increase in the labor onset. It was suggested that TLR4 may induced preterm labor.4. Immune response and immune regulation are complex processes in the occurrence and progression of premature delivery. It was possibly proven that TLR2, TLR4 and PTX3 are all involved in these pro gresses and they probably have direct or indirect influence on these.