中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (13): 2299-2303.doi: 10.3969/j.issn.1673-8225.2011.13.006

• 人工假体 artificial prosthesis • 上一篇    下一篇

假体置入患者外周血白细胞Toll样受体2和4的表达

张紫机1，康  焱1，翟齐毅1，张  浩1，张阳春1，侯昌禾1，李子卿1，盛璞义1,2，廖威明1   

  1. 1中山大学附属第一医院关节外科，广东省广州市  510080
    2中山大学附属第一医院黄埔关节外科中心，广东省广州市  510700?
  • 收稿日期:2010-09-19 修回日期:2010-10-20 出版日期:2011-03-26 发布日期:2011-03-26
  • 通讯作者: 盛璞义，双临床博士，副教授，副主任医师，中山大学附属第一医院关节外科，广东省广州市 510080；中山大学附属第一医院黄埔关节外科中心，广东省广州市510700? shengpuyi@hotmail.com
  • 作者简介:张紫机☆，男，1984年生，广东省河源市人，汉族，中山大学附属第一医院关节外科在读博士，医师，主要从事关节置换术后感染和软骨组织工程研究。 zhangziji1984@sina.com
  • 基金资助:

     广东省科委国际合作项目(2006B5010 7004)，广东省科委科技计划项目(2007B010600048)，芬兰坦佩雷大学科研基金项目(9J114)。

Toll-like receptor 2 and 4 expression in peripheral blood leukocytes of patients following prosthesis implantation 

Zhang Zi-ji1, Kang Yan1, Zhai Qi-yi1, Zhang Hao1, Zhang Yang-chun1, Hou Chang-he1, Li Zi-qing1, Sheng Pu-yi1,2, Liao Wei-ming1    

  1. 1Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou  510080, Guangdong Province, China
    2Huangpu Joint Surgery Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou  510700, Guangdong Province, China 
  • Received:2010-09-19 Revised:2010-10-20 Online:2011-03-26 Published:2011-03-26
  • Contact: Sheng Pu-yi, Doctor, Associate professor, Associate chief physician, Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China; Huangpu Joint Surgery Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China shengpuyi@hotmail. com
  • About author:Zhang Zi-ji☆, Studying for doctorate, Physician, Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China zhangziji1984@sina.com
  • Supported by:

    the International Cooperation Program of Guangdong Provincial Science and Technology Commission, No. 2006B50107004*; the Science and Technology Development Program of Guangdong Provincial Science and Technology Commission, No. 2007B010600048*; the Scientific Research Foundation Program of University of Tampere, Finland, No. 9J114*

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摘要：

背景：研究证实全髋关节置换后松动假体表面生物膜中表达Toll样受体，但其变化规律尚不清楚。
目的：观察关节假体置入患者外周血白细胞Toll样受体2，4的表达。
方法：选择关节置换患者和同期10例行关节镜检查患者，于入院次日和假体置入后第3天早晨空腹抽取肘静脉血，流式细胞术分析外周血白细胞中Toll样受体2和Toll样受体4的阳性表达，同时送血样至检验科检查白细胞、血沉、C-反应蛋白水平。
结果与结论：两组白细胞、血沉、C-反应蛋白均在正常范围内。Toll样受体2，4均主要表达于外周血单核细胞，而在外周血淋巴细胞和中性粒细胞的表达率较低；关节置换组术后外周血单核细胞Toll样受体2阳性表达率明显低于术前(P < 0.05)；关节置换组Toll样受体4、关节镜组Toll样受体2，4手术前后阳性表达率差异无显著性意义(P > 0.05)。关节置换组手术前后外周血单核细胞Toll样受体2阳性表达率低于关节镜组(P < 0.05)，两组Toll样受体4表达率无差异。提示在无感染的情况下，手术本身应激和局部损伤不影响Toll样受体2，4的表达，假体的置入下调了外周血Toll样受体2的表达。

关键词: 关节置换, 假体, Toll样受体, 流式细胞术, 人工假体

Abstract:

BACKGROUND: Toll-like receptors (TLRs) are expressed on the surface of biofilms in loosening hip prosthesis. However, the expression changes remain unclear.
OBJECTIVE: To investigate the expression of TLR 2 and 4 in leukocytes of patients undergoing joint prosthesis implantation.
METHODS: Fasting blood plasma samples were harvested from elbow veins 24 hours post admission and 3 days post-operation from patients undergoing arthroplasty or arthroscopy (n=10). Cell-associated TLR 2 and 4 was measured by flow cytometry, white blood cells, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were tested.
RESULTS AND CONCLUSION: WBC, ESR, CRP were at normal level in both groups. TLR2 and 4 were mostly expressed in monocytes of peripheral blood, with low expression levels in lymphocytes and neutrophils. The expression levels of TLR2 was significantly reduced following operation (P < 0.05), but no significant difference was observed in the expression levels of TLR4 in arthroplasty group or TLR2 and 4 in arthroscopy group between post-operation and pre-operation (P > 0.05), whereas a significant change of TLR9 expression gap was found in arthroplasty patients before and after the procedure (P < 0.05). TLR 4 expression remained unchanged (P > 0.05). The TLR2 positive expression rate in monocytes of peripheral blood was significantly lower in arthroplasty group compared with arthroscopy group (P < 0.05), but no difference was found in TLR4 expression. Results show that in the absence of clinical infection, stress and tissue damage during arthroplasty and arthroscopy do not affect TLR2 and 4 expression, but TLR2 expression was downregulated following implantation of joint prosthesis.

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