[The change in expression of Toll-like receptor 4 on peripheral blood mononuclear cell after continuous renal replacement therapy in patients with sepsis].
OBJECTIVE
To explore the change in Toll-like receptor 4 (TLR4) of peripheral blood mononuclear cell (PBMC) and the expression of cytokines in patients with sepsis, and to investigate the role of continuous renal replacement therapy (CRRT) in its modulation.


METHODS
A clinical study was performed in 13 patients with sepsis which were divided into improved group (n=7) and healing group (n=6), according to their outcome. Another 6 healthy individuals served as normal control. The mRNA expression of TLR4 on PBMC was detected by reverse transcription-polymerase chain reaction (RT-PCR), the protein expression of TLR4 on PBMC was assayed with flow cytometry, the expressions of IL-6 and TNF-alpha were measured by enzyme linked immunoadsorbent assay (ELISA).


RESULTS
TLR4 mRNA, IL-6, TNF-alpha, and TLR4 protein expressions were upregulated markedly in patients suffering from sepsis. The above parameters were decreased significantly after CRRT (all P<0.05) and in the same time, the clinic condition turn up, in the meanwhile, the expression of TLR4 went down, but it still have some expression on monocyte in improved group.


CONCLUSIONS
The down regulation of TLR4 through CRRT may imply an important mechanism in the CRRT on patients with sepsis.
Wang
Shao-dong
SD
Department of Emergency, Military General Hospital of Nanjing Military Command, Nanjing 210005, Jiangsu, China.
Zhang
Xing-quan
XQ
Wu
Xue-hao
XH
Cao
Gang
G
Xia
Xin-yi
XY
Tang
Wen-jie
WJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy; D018805:Sepsis / Q000097:blood* / Q000628:therapy; D051197:Toll-Like Receptor 4 / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D015850:Interleukin-6; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4; D014409:Tumor Necrosis Factor-alpha