The Expression And Clinical Significance Of Inflammasome In Non-infectious Febrile Cases After Chemotherapy Of Hematological Diseases

Objective The expression level and predictive value of peripheral blood inflammasome gene(NALP1,NLRP3,NLRC4,AIM2,ASC,caspase-1)and cytokines il-1 ? and il-18 were studied in the non-infectious febrile after chemotherapy.Method Collection of tianjin first central hospital onset in November 2015 to October 2015 after chemotherapy in hematologic malignancies treated non-infectious fever cases 37 cases,the same period in 32 cases of infectious fever cases as control group,were retrospectively analyzed.A real-time quantitative PCR method was used to detect the mRNA expression levels of NALP1,NLRP3,NLRC4,AIM2,ASC and caspase-1 in peripheral blood.The enzyme linked immunosorbent assay was used to detect il-1 and il-18 in peripheral blood.The neutrophils count and monocyte count were collected.Lactate dehydrogenase,hypersensitive CRP,iron protein level;Results of bacterial culture of body fluids and secretions;Examination results of ultrasound,radiology and nuclear medicine;The primary level of calcitonin was detected by immunofluorescence sandwich method.The iron protein level was detected by chemiluminescence immunoassay.A G test was performed to test the G test,and the double antibody sandwich method was used to test the GM test.Result(1)inflammatory cytokines complex NLRP3 gene mRNA expression and the level of IL-18 in blood disease(acute myeloid leukemia,malignant lymphoma)induction therapy,non-infectious fever cases increased,compared with infectious fever cases,statistically significant difference(P < 0.05).(2)blood disease(acute myeloid leukemia,malignant lymphoma)also strengthen treatment,and IL-18 NLRP3 gene expression level in non infectious fever cases,compared with infectious fever cases,statistically significant difference(P < 0.05).The level of NLRP3 gene expression and il-18 was elevated in non-infectious febrile cases(P<0.05).There was no statistically significant difference between NLRP3 gene expression and il-18 level after the granulocyte deficiency(<1.00 x 109/L)and granulocyte recovery(>2.00 x 109/L)in non-infectious febrile patients(P>0.05).The difference was statistically significant(P<0.05).The expression of NLRP3 gene and the level of il-18 were correlated with mononuclear cell ratio,lactate dehydrogenase and hypersensitive CRP.There was no correlation between ultrasound,radiology and nuclear medical examination results with the patient age,iron protein,calcitonin,G test,GM test results,fluid and secretion bacteriological culture results.Conclusion The expression of the inflammasome NLRP3 gene and the level of il-18 were elevated in non-infectious febrile fever after the chemotherapy of hematologic disease,which can be used as one of the indicators to predict non-infectious fever.