[Expression of Serum HMGB1 and CD14+ mononuclear Toll-like Receptors in Children with Hemophagocytic Syndrome and Their Effect on Prognosis]

Abstract

Objective: To detect the expression of serum HMGB1 and CD14⁺ monocyte Toll-like receptors in children with hemophagocytic syndrome (HPS), and to analyze its effect on the prognosis of children.

Methods: Eight-three children with HPS admitted in Department of pediatrics of Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected and enrolled in HPS group, at the same time 50 healthy children with same age were selected and enrolled in control group. The peripheral blood of children in 2 groups was collected. The flow cytometry was used to detect the expression of Toll-like receptors (TLR2, TLR4 and TLR6) in peripheral blood CD14⁺ monocytes, the ELISA was used to detect the expression of HMGB1 in serum of peripheral blood. The relationship of TLR2, TLR4, TLR6 and HMGB1 expression with the clinical parameters, short-term therapentic efficacy and prognosis was analyzed, the relation of TLR2, TLR4 and TLR6 expression with HMGB1 also was analyzed.

Results: The expression of TLR2, TLR4 and TLR6 on surface of CD14⁺ monocytes and fluorescence intensity in HPS group were significantly higher than those in control group (P＜0.05). The serum HMGB1 level in HPS group was significantly higher than that in control group (P＜0.05). The expression levels of TLR2, TLR4, TLR6 and HMGB1 in HPS children who were in acute phase or had decrease of albumin or hemoglobin levels, thrombocytopenia, neutrophil absolute value to low and increase of triglycerides level, in HPS group all significantly increased, the difference in children with different sex and age was no statistically significant (P＞0.05). After treatment, the expressions of TLR2, TLR4, TLR6 and HMGB in CR and NAD groups was significantly lower than that before treatment (P＜0.05), while the expressions levels of TLR2, TLR4, TLR6 and HMGB in AD and RD groups were no statistically significant different from those before treatment (P＜0.05); the expressions levels of TLR2, TLR4, TLR6 and HMGB in dealth group all were higher than those in survival group (P＜0.05). The serum HMGB1 levels in HPS children positively correlated with expression of TLR2, TLR4 and TLR6 on CD14⁺ monocytes (P＜ 0.05).

Conclusion: The expression rate and level of TLR2, TLR4 and TLR6 on CD14⁺ monocytes in HPS children are significantly higher than those in healthy children.The expression levels of TLR2, TLR4, and TLR6 positively correlate with serum HMGB1 content, which provides reference for the diagnosis and prognosis of children with HPS.