胸腰椎压缩性骨折老年患者肺部感染对TLR7/IL-23/IL-17信号通路的影响

摘要

目的 探讨胸腰椎压缩性骨折老年患者肺部感染对Toll样受体7(TLR7)/白细胞介素23(IL-23)/IL-17信号通路的影响.方法 前瞻性分析2014年5月至2017年3月收入96例胸腰椎压缩性骨折且发生肺部感染的老年患者资料.使用ELISA检测患者肺部感染前后血清中IL-2、IL-6、IL-8、IL-10、C反应蛋白(CRP)、肿瘤坏死因子 α(TNF-α)、IL-17和IL 的含量;使用流式细胞仪分析血液标本中CD4+、CD8+免疫细胞的分群与比率;使用全自动生化检测仪分析血液标本中IgG、IgA、IgM免疫抗体的含量;使用荧光定量PCR和Western blot检测外周血单个核细胞TLR7mRNA和蛋白的表达.结果 胸腰椎压缩性骨折老年患者肺部感染后,血清中IL-2、IL-6、IL-8、IL-10、 CRP、TNF-α的表达水平显著增高,CD8 +免疫细胞和IgG、IgM免疫抗体显著降低,CD4+细胞和IgA免疫抗体与感染前相比较无统计学差异.与感染前比较,肺部感染后血清中IL-17和IL-23的蛋白表达显著增高,TLR7mRNA和蛋白的表达显著降低.结论 胸腰椎压缩性骨折老年患者肺部感染可以抑制TLR7的表达,从而促进IL-23/IL-17信号通路的活化.%Objective To explore the influence of pulmonary infection on the TLR7/IL- 23/IL- 17 signaling pathway in the thoracolumbar compression fracture patients. Methods 96 thoracolumbar compression fracture patients with pulmonary infection were analyzed. Elisa was performed to assess the expression levels of IL-2, IL-6, IL- 8, IL- 10, CRP,TNF- a, IL-17 and IL-23 in serum. Flow cytometry detected the proportion of CD4 + and CD8 + immune cells. Automatic biochemical detector determined the content of IgG, IgA and IgM. Elisa and western blot were performed to examine the mRNA and protein expression of TLR7 in peripheral blood mononuclear cell. Results The expression levels of IL- 2, IL- 6,IL- B, IL- 10,CRP and TNF- a in serum were significantly increased. The contents of CD8 + immune cells, IgG and IgM were significantly decreased. Compared with pre- infection, the protein expression of IL- 17 and IL-23 were significantly increased, however, the mRNA and protein expression of TLR7 were significantly decreased. Conclusion Pulmonary infection results in the decreased expression of TLR7 and increased expression of IL- 17 and IL-23 in the thoracolumbar compression fracture patients.