[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.

Conclusion: The down regulation of TLR4 through CRRT may imply an important mechanism in the CRRT on patients with sepsis.