| Objective: To detect the expression levels of Toll like receptor 3(TLR3)and IL-4in the labial glands of patients with Sj?gren's syndrome(SS)and analyze the relationship between the two indexes and the main clinical manifestations of SS and related laboratory examination indexes,and search their roles in the pathogenesis of SS,to find a new index for clinical diagnosis and treatment of SS.Methods: 74 patients with SS were selected as the observation group,including primary Sj?gren's syndrome(pSS)in 50 cases,and secondary Sj?gren's syndrome(sSS)in 24 cases.32 cases of non-SS patients were selected as control group which had treated in the same period.Elivision immunohistochemical staining was used to detect the expressions of TLR3 and IL-4 in the pathological sections of labial glands in all patients,and the qualitative and semi quantitative analysis of the results were performed by manual counting.SPSS 22.0 statistical software was used for statistical analysis,the count data was expressed by [n(%)],?2 test was applied for the positive rate comparison;the measurement data was expressed as mean ± standard deviation(x ± s),The means of two samples were compared by t test and the SNK-q test was used to compare the mean values between groups,Spearman coefficient of rank correlation was used to correlation analysis.The test level was set as ?=0.05,and the difference was statistically significant with P<0.05.Results: 1.Expression of TLR3 and IL-4:(1)The positive expression rates of TLR3 in the labial gland of observation group and control group were 44.6% and12.5%,respectively,there was significant difference(?2=8.764,P=0.003).The color intensities of TLR3 in the observation group and control group were 0.514±0.625 and0.156±0.448,respectively,there was significant difference(t=3.325,P=0.001);Thestaining integrals of TLR3 in the observation group and control group were0.649±1.026 and 0.344±0.653,respectively,there was significant difference(t=2.409,P=0.018).(2)The positive expression rates of IL-4 in the labial gland of observation group and control group were 71.6% and 25.0%,respectively,there was significant difference(?2=19.876,P=0.000).The color intensities of IL-4 in observation group and control group were 0.946±0.719 and 0.250±0.440,respectively,there was significant difference(t=5.070,P=0.000);The staining integrals of IL-4 in observation group and control group were 1.405±1.489 and 0.219±0.751,respectively,the difference was statistically significant(t=5.103,P=0.000).2.The correlation between expression of TLR3 and IL-4: There was no statistically significant correlation between the expression of TLR3 and IL-4,either in the color intensity or the staining integral(all P>0.05).3.The expressions of TLR3 and IL-4 in patients with different types of SS were compared with those in control group: The expression levels of TLR3 and IL-4 in patients with pSS and sSS were higher than those in control group,and the differences were statistically significant(all P<0.05).But,there were no significant differences in the expression levels of TLR3 and IL-4 between the pSS patients and sSS patients(all P>0.05).4.Analysis of clinical manifestations and relevant laboratory examinations:(1)Analysis of clinical manifestations: In pSS and sSS patients,the incidences of xerostomia,dry keratitis,cutaneous vasculitis and joint pain were higher than those of the control group,but the incidences of above-mentioned clinical manifestations in pSS patients and sSS patients were not statistically significant(all P>0.05).(1)There were no statistically significant differences in the expression levels of TLR3 between patients with and without xerostomia and arthralgia(all P>0.05).(2)The expression levels of IL-4 in patients with xerostomia and arthralgia were significantly higher than those without above-mentioned clinical manifestations,and there were significant differences(all P<0.05).(3)There were no statistically significant differences in the expression levels of TLR3 and IL-4 between the patients with or without keratoconjunctivitis sicca and cutaneous vasculitis(all P>0.05).(2)Analysis of relevant laboratory examinations:(1)The positive rates of autoantibodies anti-SSA and anti-SSB in pSS and sSS patientswere significantly higher than the control group,but the positive rates of anti-SSA and anti-SSB in pSS patients and sSS patients had no significant differences(all P >0.05).There were no significant differences in the expression levels of TLR3 in anti-SSA,anti-SSB positive and negative patients(all P>0.05).The chromogenic expression levels of IL-4 in anti-SSA and anti-SSB positive patients were higher than those of negative patients,and had statistically significant differences(all P<0.05).(2)Analysis the correlation between TLR3 and IL-4 positive expression with ESR,CRP,IgG,IgM,IgA and other laboratory indicators : the positive expression of TLR3 and the laboratory indicators of all patients were showing no statistically significant correlation(all P >0.05).There was a positive correlation between the positive expression of IL-4 and the laboratory parameters of the patients with IgG(r=0.198,P=0.042).Conclusions: 1.The expression level of TLR3 in labial glands of SS patients increased significantly,suggesting that TLR3 signaling pathway may be involved in the pathogenesis of SS.2.The positive expression of IL-4 was positively related to the level of IgG in patients,and it highly expressed in patients with positive autoantibodies and with SS related clinical symptoms,suggesting that IL-4 may be related to the pathogenesis and the activity of SS.3.There was no significant difference in the expression levels of TLR3 and IL-4 in the labial glands between patients with pSS and sSS,suggesting that TLR3 and IL-4 may be the same route of involvement in the pathogenesis of these two diseases. |
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