Objective To investigate the expression of Toll-like receptor 4 (TLR4)in peripheral blood monocytes and its correlation with TNF-α and IL-6 in type 2 diabetes (T2DM)patients with neuropathy. Methods Healthy volunteers (NC,n=44),T2DM without neuropathy (n=44)and T2DM with neuropathy (n=44)were recruited in the present study.The expression of TLR4 mRNA and protein in peripheral blood monocytes was detected by RT-PCR and flow cytometry. ELISA was undertaken to measure the plasma concentration of TNF-αand IL-6. Results The levels of HbA1 c[(9.09±1.62)%vs(8.36±1.10)% vs (5.30±0.89)%],the protein expression of TLR4[(42.02±9.69)% vs (31.27± 6.87)% vs (11.96±5.54)%],the mRNA expression of TLR4[(2.98±1.06)vs (1.74±0.47)vs (1.12 ±0.52)],TNF-α[(8.75±3.14 )vs (6.27±3.64)vs(3.19±1.17)pg/ml]and IL-6[(3.63±1.81)vs(2.60 ±1.14)vs(1.54±0.58)pg/ml]in patients with diabetic neuropathy significantly increased compared with T2DM and NC group;TLR4 showed a positive correlation with TNF-αand IL-6(r=0.631,P <0.0001;r=0.447,P =0.0023). Conclusion TLR4 of monocytes may take part in the occurrence of systemic inflammation and has a close relationship with the development of diabetic neuropathy.%目的：研究 T2DM 伴糖尿病神经病变患者外周血单核细胞 TOLL 样受体4（TLR4）的表达及其与促炎因子 TNF-α、IL-6的相关性。方法将研究对象分为正常组（NC，n＝44），T2DM 组（n＝44），T2DM 神经病变组（n＝44）。分离和提取外周血单核细胞，流式细胞术和 RT-PCR 检测单核细胞表面 TLR4蛋白和 mRNA；ELISA 检测血浆 TNF-α和 IL-6。结果 T2DM 神经病变组 HbA1 c[（9．09±1．62）％ vs（8．36±1．10）％ vs （5．30±0．89）％]、单核细胞 TLR4蛋白[（42．02±9．69）％ vs （31．27±6．87）％ vs （11．96±5．54）％]和 TLR4 mRNA[（2．98±1．06）vs （1．74±0．47）vs （1．12±0．52）]、血浆TNF-α[（8．75±3．14）vs （6．27±3．64）vs （3．19±1．17）pg／ml]、IL-6[（3．63±1．81）vs （2．60±1．14）vs （1．54±0．58）pg／ml]水平均高于 T2DM 和 NC 组（P ＜0．01）；T2DM 神经病变组 TLR4蛋白与 TNF-α、IL-6呈正相关（r＝0．631，P＜0．0001；r＝0．447，P ＝0．0023）。结论糖尿病神经病变患者单核细胞TLR4参与机体炎症反应，与糖尿病神经病变的发生发展密切相关。
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