Clinical Significance Of H0-1 And CD14/TLR-4 In Secondary Hemophagocytic Lymphohistiocytosis

ObjectiveTo explore the levels and clinical significance of serum heme oxygenase-1(HO-1)in patients with secondary hemophagocytic lymphohistiocytosis(sHLH).MethodsSerum HO-1 levels were determined by using enzyme linked immunosorbent assays(ELISA)in 43 sHLH patients and 12 healthy controls.Clinically relevant laboratory datas were collected,and the correlations with HO-1 were explored.Results(1)Serum HO-1 levels in the newly diagnosed group were found to be significantly higher than those in the control group(P=0.001).(2)Serum HO-1 levels in the newly diagnosed autoimmune-associated HLH(AHLH)group were significantly higher than those in infection-associated HLH(IHLH,P<0.05)group and lymphoma-associated HLH(LHLH,P<0.05)group.(3)The serum HO-1 levels in the clinical remission group decreased sharply comparing with the pre-therapy group(P<0.01).(4)Serum HO-1 levels in newly diagnosed sHLH patients positively correlated with SF(r=0.582,P<0.001).(5)In AHLH group(n=7),the serum HO-1 levels in dead group were significantly higher than those in the survive group(P=0.04).ConcusionSerum HO-1 levels are clinically significant in disease diagnosis,differential diagnosis of AHLH,evaluating disease activity and treatment outcomes in patients with sHLH.ObjectiveTo investigate the expression of TLR-4 on peripheral blood CD 14+ monocytes in patients with secondary hemophagocytic lymphohistiocytosis(sHLH),and to discuss its clinical significance.MethodsA totol of 20 patients with sHLH and 10 healthy controls were enrolled in this study.Peripheral blood was collected and the expression of TLR-4 on CD 14+monocytes was tested by flow cytometry.Clinical parameters were collected,and the correlations with TLR-4 on CD 14+monocytes were explored.Results(1)The expression of TLR-4 on CD 14+monocytes in the newly diagnosed group was significantly higher than that of healthy control group(P=0.001).(2)The expression of TLR-4 on CD 14+monocytes in the infection-associated HLH group(IHLH)was significantly higher than that of the autoimmune-associated HLH group(AHLH)(P=0.011)and the lymphoma-associated HLH group(LHLH)(P=0.008).However,no significance were found in the expression of TLR-4 on CD 1-4+monocytes between AHLH group and LHLH group(P>0.05).(3)The expression of TLR-4 on peripheral blood CD 14+monocytes in the clinical remission group(n=8)was significantly lower than that of the pre-therapy group(P=0.04).(4)The expression of TLR-4 on CD14+monocytes in the positive group(n=13)was positively correlated with PCT(r=0.88,P<0.001).ConclusionThe expression of TLR-4 on peripheral blood CD 14+monocytes in sHLH significantly increased,especially in IHLH patients,which has important significance for the differential diagnosis of IHLH.The expression of TLR-4 on peripheral blood CD 14+monocytes maybe an important indicator of monitoring the condition change.