RESUMO
BACKGROUND: Inflammation is one of the main contributors to atherosclerosis in haemodialysis (HD) patients. Activation of Toll-like receptors (TLRs) leads to inflammatory response. In this study, we aimed to evaluate the expression of TLRs on monocytes and relate their expression with inflammation in chronic kidney disease (CKD) and HD patients. METHODS: Thirty-four age- and gender-matched controls and stage 3-4 CKD patients and thirty-two HD patients were included in each study group. The effect of HD on the expression of Toll-like receptor-2 (TLR-2) and Toll-like receptor-4 (TLR-4) on CD14( +) monocytes was determined at the beginning (baseline), during (120 min) and following (300 min and 24 h) HD and compared with control and stage 3-4 CKD groups. The HD procedure was performed by using low-flux polysulphone dialysers. In addition, serum IL-6 levels were evaluated in both groups at baseline and after a HD session. RESULTS: The percentage of CD14( +) monocytes expressing TLR-2 were similar in all of the study groups, whereas the percentage of CD14( +) monocytes expressing TLR-4 were significantly lower in both stage 3-4 CKD and HD patients at baseline than in controls. The mean fluorescence intensities (MFI) of TLR-2 were significantly lower in controls than in stage 3-4 CKD and HD patients at baseline. The MFI of TLR-4 was similar in all of the groups. The percentage of CD14( +) monocytes expressing TLR-2 did not change during and after HD. The MFI of TLR-2 decreased at 120 min of HD compared with baseline (1837 ± 672 vs 1650 ± 578, P < 0.05), and recovered back to baseline values at 300 min and at 24 h post-HD. MFI of TLR-4 increased at 24 h compared with baseline (941 ± 294 vs 1087 ± 441, P < 0.05). Serum IL-6 levels correlated with MFI of TLR-2 and TLR-4 in stage 3-4 CKD patients and in HD patients at baseline and after HD in univariate analysis. Stepwise multiple regression analysis revealed that MFI of TLR-2 was an independent determinant of serum IL-6 concentrations in stage 3-4 CKD and in HD patients at baseline, at 300 min and at 24 h post-HD. Conclusions. Our study demonstrates that TLR-2 is associated with the inflammatory response of non-dialysed and dialysed CKD patients.
Assuntos
Inflamação/etiologia , Falência Renal Crônica/metabolismo , Monócitos/metabolismo , Diálise Renal , Receptor 2 Toll-Like/metabolismo , Receptor 4 Toll-Like/metabolismo , Estudos de Casos e Controles , Feminino , Citometria de Fluxo , Taxa de Filtração Glomerular , Humanos , Inflamação/metabolismo , Interleucina-6/sangue , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de RiscoRESUMO
The objective of this study was to investigate the expressions of toll-like receptors on neutrophils and monocytes in Behcet's disease (BD). Forty-two patients with BD were included in the study. Baseline and stimulated cells with heat shock protein-60 (HSP-60), lipopolysaccharide (LPS) and crude extract of Streptococcus sanguis (SS) were analyzed for toll-like receptor-1, -2, -4 and -6 expressions using flow cytometer. Results were confirmed using semi-quantitative PCR technique. The mean frequency of TLR-6 expressing granulocytes in BD patients was significantly lower than in controls (4.2 +/- 0.6 vs. 9.2 +/- 0.6 and 8.0 +/- 1.4, BD vs. rheumatoid arthritis (RA) and healthy control (HC); P < 0.05). TLR-6 expressing granulocyte population was enhanced after stimulation with HSP-60 and SS (20 +/- 0.5 and 12.8 +/- 0.6, respectively). Decreased TLR-2 expression was noted in monocytes of BD patients after stimulation with HSP-60 and LPS (71.0 +/- 0.5 and 73.0 +/- 0.5; P < 0.02, for both antigens). Functional abnormalities of these receptors or different activation cascades by different microorganisms are associated with disease pathogenesis in Behcet's disease.
Assuntos
Síndrome de Behçet/metabolismo , Granulócitos/metabolismo , Monócitos/metabolismo , Receptor 6 Toll-Like/metabolismo , Adolescente , Adulto , Artrite Reumatoide/metabolismo , Síndrome de Behçet/imunologia , Síndrome de Behçet/microbiologia , Estudos de Casos e Controles , Feminino , Humanos , Imunidade Inata , Masculino , Pessoa de Meia-Idade , Receptor 2 Toll-Like/metabolismoRESUMO
OBJECTIVE: To investigate serum levels of mannose-binding lectin (MBL), a complement-like protein of collectin family, in patients with Behcet's disease (BD). METHODS: MBL levels were measured in sera of 130 patients with BD, 64 patients with recurrent oral ulcerations (ROU), and 105 healthy controls (HC) with ELISA. RESULTS: Patients with BD had significantly lower median serum MBL levels compared to HC (1857 vs 3136 ng/ml, p = 0.001). No significant difference was observed in median serum MBL levels between BD and ROU (2309 ng/ml, p = 0.252). Low MBL levels (/= 4) was more frequently observed in BD patients with very low serum MBL levels (
