Objective To investigate the expression of Toll-like receptors 2 (TLR2) mRNA,p38 mitogen activated protein kinase(p38 MAPK) mRNA and cytokine in peripheral blood of children with measles and to study the effect and possible mechanism for TLR2-p38 MAPK signal pathway defects on immune suppression in the children with measles during acute phase.Methods Thirty children with measles hospitalized in the department of infectious diseases from June 2012 to July 2013 were enrolled into the measles group,and 30 healthy children were chosen as the healthy control group.The mRNA expressions of TLR and p38 MAPK in peripheral blood mononuclear cells (PBMC) were detected by reverse transcription-polymerase chain reaction (RT-PCR).The protein levels of interferon-γ (IFN-γ),tumor necrosis factor-β (TNF-β),interleukin (IL)-12,IL-6 and IL-10 in plasma were measured by using enzyme linked immunosorbent assay (ELISA),and flow cytometry (FCM)was applied to detect the percentage of lymphocyte subpopulation.The serum IgG,IgA and IgM levels were detected by velocity scatter turbidimetry.Results (1) The expressions of TLR2 mRNA and p38 MAPK mRNA in the measles group were both significantly lower than those in the healthy control group (all P ＜ 0.05).(2) Compared with the healthy control group,the protein levels of IFN-γ,TNF-β and IL-12 in the plasma of the measles group decreased significantly (all P ＜ 0.05),and the levels of IL-6 and IL-10 increased significantly(all P ＜ 0.05).(3)Compared with the healthy control group,the percentage of CD3 +,CD4 +,CD4 +/CD8 + ratio and the level of IgG and IgA in the measles group decreased significantly(all P ＜ 0.05),and the percentage of CD19 + increased significantly(P ＜ 0.05),but there was no any significant change in the percentage of CD8 + and the level of IgM (all P ＞ 0.05).Conclusions The mRNA expressions of TLR2 and p38 MAPK are low in PBMC in the measles children during acute phase.There are different degrees of suppression of cell immunity,humoral immune and cytokines disorder in children with measles.Defects of TLR2-p38 MAPK signal pathway may cause the formation of measles immune suppression.%目的 检测麻疹患儿外周血Toll样受体2(TLR2)、p38有丝分裂素激活蛋白激酶(p38 MAPK)和细胞因子的表达,探讨TLR2-p38 MAPK信号途径在麻疹急性期导致的免疫抑制中的作用.方法 选择2012年6月至2013年7月华中科技大学同济医学院附属荆州医院住院的麻疹患儿30例为麻疹组,30例健康体检儿童作为健康对照组.采用反转录-聚合酶链反应(RT-PCR)检测2组外周血单个核细胞(PBMC) TLR2mRNA、p38 MAPK mRNA的表达;采用酶联免疫吸附法(ELISA)检测血浆中干扰素-γ(IFN-γ)、肿瘤坏死因子-β(TNF-β)、白细胞介素(IL)-12、IL-6、IL-10的水平;采用流式细胞仪(FCM)和速率散射比浊法分别检测外周血淋巴细胞亚群及免疫球蛋白水平.结果 1.麻疹组PBMC TLR2 mRNA、p38MAPK mRNA表达均明显下降,与健康对照组比较差异均有统计学意义(P均＜0.05).2.麻疹组血浆中IL-12、IFN-γ 、TNF-β均明显下降,与健康对照组比较,差异均有统计学意义(P均＜0.05);IL-6、IL-10均明显升高,与健康对照组比较差异均有统计学意义(P均＜0.05).3.麻疹患儿组PBMC CD3+、CD4+、CD4 +/CD8+、IgG、IgA均明显下降,与健康对照组比较,差异均有统计学意义(P均＜0.05);CD19+明显升高,与健康对照组比较差异有统计学意义(P＜0.05);CD8+及IgM与健康对照组比较差异均无统计学意义(P均＞0.05).结论 TLR2 mRNA、p38 MAPK mRNA在急性期麻疹患儿PBMC中呈低水平表达.急性期麻疹患儿同时存在不同程度的细胞免疫抑制、体液免疫抑制及细胞因子紊乱.TLR2-p38 MAPK信号途径缺陷可能参与了麻疹免疫抑制的形成.
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