摘要
目的分析口腔单纯疱疹病毒1型(herpes simplex virus type 1,HSV-1)感染患儿Toll样受体9(Toll like receptors 9,TLR9)、髓样分化蛋白88(myeloid differentiation factor 88,MyD88)及相关细胞因子的表达水平,探讨HSV-1感染患儿TLR9、MyD88及相关细胞因子与预后复发的相关性。方法选取2021年1月至2024年6月在山东第一医科大学附属人民医院接受治疗的170例口腔HSV-1感染患儿,根据随访期间是否再次发生感染将患儿分为复发组和未复发组。采用实时荧光定量PCR技术检测患儿外周血中TLR9、MyD88 mRNA表达量;采用磁微粒化学发光法检测患儿血清白细胞介素(IL)-6、IL-10水平;通过logistic回归分析确定影响口腔HSV-1感染患儿预后复发的危险因素;Pearson相关性分析法用于评估TLR9、MyD88及相关细胞因子与口腔HSV-1感染患儿预后复发的相关性。结果根据随访检测结果,170例患儿中58例发生口腔HSV-1感染,纳入复发组;余下112例未发生口腔HSV-1感染,纳入未复发组。复发组患儿外周血TLR9、MyD88 mRNA及TLR9、MyD88共表达水平均高于未复发组[(95.75±5.47)%vs.(52.47±3.71)%、(70.59±4.32)%vs.(29.17±1.73)%和(71.53±5.75)%vs.(16.24±1.77)%],差异有统计学意义(P<0.05)。与未复发组比较,复发组患儿血清IL-6、IL-10水平明显升高[(82.16±6.47)pg/mL vs.(38.51±4.29)pg/mL,(6.37±0.94)pg/mL vs.(2.05±0.43)pg/mL],差异有统计学意义(P<0.05)。两组在免疫力低下、微量元素/维生素缺乏、密切接触感染源、TLR9、MyD88、IL-6以及IL-10水平方面比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,免疫力低下、微量元素/维生素缺乏、密切接触感染源、TLR9、MyD88、IL-6以及IL-10是口腔HSV-1感染患儿预后复发的主要危险因素(P<0.05)。Pearson相关性分析结果显示,TLR9、MyD88、IL-6、IL-10与口腔HSV-1感染患儿预后复发均呈显著正相关(r=0.8591、0.8567、0.8371、0.8265,P<0.001)。结论口腔HSV-1复发感染患儿TLR9、MyD88、IL-6、IL-10水平均明显升高,TLR/MyD88信号通路可能在口腔HSV-1复发感染患儿预后复发机制中具有重要作用。
Objective To explore the correlation between the expression of Toll-like receptor 9(TLR9),myeloid differentiation factor 88(MyD88),and related cytokines with the prognosis and recurrence of oral herpes simplex virus type 1(HSV-1)infection in children.MethodssA total of 170 children with oral HSV-1 infection treated at the Affiliated People's Hospital of Shandong First Medical University between January 2021 and June 2024 were enrolled.Based on whether they experienced recurrent infections during follow-up,the children were divided into a recurrence group and a non-recurrence group.Real-time fluorescent quantitative PCR was used to measure the mRNA expression levels of TLR9 and MyD88 in peripheral blood,and magnetic particle chemiluminescence was used to detect serum interleukin(IL)-6 and IL-10 levels.Logistic regression analysis was performed to identify the risk factors for recurrent oral HSV-1 infection in children.Pearson correlation analysis was used to evaluate the correlation between TLR9,MyD88,and related cytokines with the prognosis and recurrence of oral HSV-1 infection in children.Results Of the 170 children,58 had recurrent oral HSV-1 infection and were included in the recurrence group,while the remaining 112 had no recurrence and were included in the non-recurrence group.The recurrence group had significantly higher levels of TLR9 and MyD88 mRNA,as well as TLR9/MyD88 co-expression,compared to the non-recurrence group:[(95.75±5.47)%vs.(52.47±3.71)%,(70.59±4.32)%vs.(29.17±1.73)%,and(71.53±5.75)%vs.(16.24±1.77)%](P<0.05).Additionally,the recurrence group had significantly higher serum IL-6 and IL-10 levels than the non-recurrence group:[(82.16±6.47)pg/mL vs.(38.51±4.29)pg/mL,(6.37±0.94)pg/mL vs.(2.05±0.43)pg/mL](P<0.05).There were significant differences between the two groups regarding immunodeficiency,deficiency of trace elements/vitamins,close contact with infection sources,TLR9,MyD88,IL-6,and IL-10 levels(P<0.05).Logistic regression analysis showed that immunodeficiency,deficiency of trace elements/vitamins,close contact with infection sources,TLR9,MyD88,IL-6,and IL-10 were significant risk factors for recurrent oral HSV-1 infection in children(P<0.05).Pearson correlation analysis indicated that TLR9,MyD88,IL-6,and IL-10 were all positively correlated with recurrence in oral HSV-1 infection in children(r=0.8591,0.8567,0.8371,0.8265,P<0.001).Conclusion The levels of TLR9,MyD88,IL-6,and IL-10 are significantly elevated in children with recurrent oral HSV-1 infection.The TLR/MyD88 signaling pathway may play an important role in the mechanism of prognosis and recurrence of oral HSV-1 infection in children.
作者
徐凤玲
吕江峰
秦爽
刘玉田
任玉国
XU Feng-ling;LYU Jiang-feng;QIN Shuang;LIU Yu-tian;REN Yu-guo(Department of Blood Transfiusion,Affiliated People's Hospital of Shandong First MedicalUniversity,Jinan 271100,Shandong,China;不详)
出处
《广东医学》
2025年第5期765-770,共6页
Guangdong Medical Journal
基金
山东大学卫生健康委员会科技计划项目(2022-2-59)。
关键词
口腔单纯疱疹病毒感染
TOLL样受体9
髓样分化蛋白88
预后复发
相关性
oral herpes simplex virus infection
Toll like receptors 9
myeloid differentiation factor 88
prognostic recurrence
relevance
