| Objective①To show the infection status of Legionella in some patients with pulmonaryinfection.②To explore the differences of the expression of TLR2,TLR4 mRNA in PBMCin Legionella infected patients, another pulmonary infected patients and healthyindividuals.③To search the effect of related cytokine in legionella infection and therelationship between which with TLR2 and TLR4。Methods①277 pulmonary infected patients in Shanxi were collected and detected for theantibodies to Legionella pneumophila serogroup 1 strains (Lp1) in urine using ELISA;A enus-specific sequence of 16S ribosome gene of Legionella in sputum wasamplified by polymerase chain reaction(PCR).②The diagnostic criteria of Legionella infection was the positive result forLp1-special antibodies or the positive result for Legionella gene in sputum.③17 individuals infected by Legionella were selected as case group,20 otherpulmonary infected patients whose result of Legionella test were negative wereselected as a control group by randomized sampling, and 20 healthy individuals whoreceived health examination in the same period were chosen as another control group.The expression of TLR2 mRNA and TLR4 mRNA in PBMC were detected byreal-time RT-PCR, search for the relationship between them and legionella infection.④.17 individuals infected by Legionella were selected as case group,20 otherpulmonary infected patients whose result of Legionella test were negative wereselected as a control group by randomized sampling,and 20 healthy individuals whoreceived health examination in the same period were chosen as another control group.The concentration of IL-1,2, 6 and TNF-αin serums of those groups were analyzed byELISA, search for the relationship among legionella infection and those cytokines andTLR2,TLR4 ⑤.All of the data was analyzed by the statistical packages SPSS 13.0.ResultResults①277 pulmonary infected patients was obtained, in which 213 urine sample weredetected for Lp1-special antibodies, and the positive rate of Lp1 was 4.0%(10/213);242 urine sample was collected for Legionella gene amplification by PCR, 10individuals'urine were positive ,The positive rate of Legionella gene was 6.58%;Only 3 sample were positive by these two method.The total positive rate of Legionellainfection was 6.13%. The infection rate of Legionella was different in various patients,it was highes(t 30.00%)in the people with hematologic disease, the second(17.64 %)was the crowd with nervous system disease, the lowest(11.71%)was COPD group.②Compare the expression of TLR2 mRNA and TLR4 mRNA in PBMC betweencase group and patient control group,case group and health control group, indicatethat the value of TLR2Ct/β-actinCt in case group is lower than in the health controlgroup, that is to say the expression of TLR2 mRNA in case group is higher than in thehealth control group, there is a statistical difference, p﹤0.0001.But there was nodifference statistically for the value of TLR2Ct/β-actinCt between the case group andthe patient control group, p=0.983. Also,TLR4 mRNA in case group is higher than inthe health control group, there is a statistical difference, p﹤0.0001.But there was nodifference statistically for the value of TLR2Ct/β-actinCt between the case group andthe patient control group, p =0.224.③The concentration of IL-2 in serum of case group is higher than of healthcontrol group(41.072±7.153pg/ml),so dose IL-6(216.663±24.346pg/ml)and TNF-α(389.348±77.832pg/ml),the differences were statistical significance. While therewas no difference of IL-1 in serum of case group is higher than of health controlgroup. IL-2 ,IL-6 were used to represent Th1,Th2 cytokine separately, there was nosignificantly difference of the value of Th1/Th2 between case group(0.3834±0.11)and health control group(0.246±0.0981). Correlation analysis showed that the rate ofTLR2Ct/β-actin Ct was negative correlated with the concentration of IL-2,IL-6 andTNF-α, the orrelation coefficient were -0.783,-0.816 and -0.664(p<0.05),that is to saythe concentration of IL-2,IL-6 and TNF-αincreased with the TLR3 mRNAincreasing,The rate of TLR4Ct/β-actin Ct was negative correlated with theconcentration of IL-1,IL-2,IL-6 and TNF-α, the orrelation coefficient were -0.691,-0.713,-0.768,-0.889(p<0.05),so the concentration of IL-1,IL-2,IL-6 and TNF-αincreased with the TLR4 mRNA increasing。 ConclusionConclusions①In pulmonary infected patients of Taiyuan, the incidence of Legionella infectionwas 6.13%.②There was no difference of TLR2 mRNA and TLR4 mRNA in PBMC betweenlegionella infected patients and other pulmonary infected patients, while both of themwere higher than healthy people, and the difference statistically. Indicate that TLR2and TLR4 may play a certain role in legionella infectiom.③TLR2,TLR4 were positive correlated with the concentration of Th1,Th2cytokines, and their biological effect may be implemented by the secretion ofcytokines.
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