The Correlation Between The Change Of TLR4 On CD₁₄⁺ PBMCs With Acute Coronary Syndrome And Serum TNF-α

OBJECTIVE The purpose of this study is to investigate the change of Toll like receptor 4 ( TLR4) on Cluster of differentiation-14 (CD₁₄⁺) peripheral blood monocytes (PBMCs) in acute coronary syndrome( ACS) patients and the associativity of serum tumor necrosis factor alpha (TNF-α) and to evaluate the value of TLR4 signaling pathway in the pathogenesis of ACS.METHODS The expression of TLR4 on CD₁₄⁺ PBMCs was mensured by flow cytometry in 16 patients with acute myocardial infarction(AMI), mean age 66±4, 14 patients with unstable angina pectoris(UAP ),mean age 68±7, 15 patients with stable angina pectoris (SAP) , mean age 64±5, and 15 controls ,mean age 61±7. The 45 patients was diagnosticated coronary artery disease(CAD ).The clinical diagnosis was according to typical clinical manifestation, myocardium enzymology, electrocardiogram and so on. Corresponding with the coronary artery disease diagnostic criteria of World Health Organization(WHO). The level of serum TNF-αwas detected in the above-mentioned 4 groups by Enzyme-linked immunsorbent assay(ELISA).RESULTS The percentage of expressions of TLR4 on PBMCs in the groups of AMI,UAP,SAP and control group were 33.15±7.46,21.75±5.45,12.97±3.15,6.22±3.77. The expressions of TLR4 in the group of with ACS(AMI and UAP)was higher than that in the group of without ACS ( P < 0.01), in the group of with AMI was higher than that in the group of UAP( P < 0.01) , in the group of with SAP was higher than control group (P <0.01). Serum TNF-αwas 53.28±11.23 ng.L^-1, 37.64±10.13 ng.L^-1,15.25±5.17 ng.L^-1, 9.60±3.67 ng.L^-1. Serum TNF-αincreased in gradually and significantly between the group of patients with ACS and the groups of without ACS. There was a significant positive correlation between the expression of TLR4 and the content of serum TNF-αin the group of patients with ACS. coefficient correlation r=0.766,P <0.01.CONCLUSIONS The expression of TLR4 in peripheral blood monocyte is higher in ACS patients than control group.The level of serum TNF-αis higher in ACS patients than control group. There was a significant positive correlation between the expression of TLR4 and the content of serum TNF-αin the group of patients with ACS. TLR4 and the inflammatory responses mediated by it may be involved in the pathogenesis of ACS and TLR4 signaling pathway in the pathogenesis of ACS may be related to the unstability of plaques.