杨宪鲁　王海燕　汤华晓　丛涛　李玲芳

[摘要] 目的 研究结节性红斑患者与健康对照人群外周血单核细胞中Toll样受体9（TLR9）和核因子-κB（NF-κB）的表达情况，并分析其在结节性红斑中的临床意义。 方法 选择2014年6月～2017年10月山东省威海市妇幼保健院及山东省威海市立医院确诊的结节性红斑患者52例作为疾病组；另选健康体检者41名作为对照组。采用实时荧光定量聚合酶链反应检测外周血单核细胞中TLR9和NF-κB的mRNA水平。 结果 疾病组外周血中TLR9 mRNA水平较对照组明显降低，差异有高度统计学意义（P < 0.01），疾病组NF-κB mRNA水平较对照组明显升高，差异有高度统计学意义（P < 0.01）。疾病组中TLR9与NF-κB的mRNA水平存在线性正相关关系（r = 0.89，P < 0.01）。 结论 与正常人群相比，结节性红斑患者TLR9 mRNA水平明显降低，NF-κB mRNA水平明显升高，提示TLR9和NF-κB可能参与了结节性红斑疾病的发病过程。

[关键词] 结节性红斑；外周血；Toll样受体9；核因子-κB

[中图分类号] R275.986.1 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0106-03

[Abstract] Objective To study the expression of Toll-like receptor 9 （TLR9） and nuclear factor-κB （NF-κB） in peripheral blood mononuclear cell of erythema nodosum patients and healthy controls and to explore the clinical significance of TLR9 and NF-κB in erythema nodosum. Methods From June 2014 to October 2017， 52 patients with erythema nodosum from Weihai Women and Children′s Hospital and Weihai Municipal Hospital of Shandong Province were enrolled as disease group， and 41 healthy physical examinees served as control group. The mRNA levels of TLR9 and NF-κB in peripheral blood mononuclear cell were detected by real-time fluorescence quantitative PCR technique. Results The level of TLR9 in disease group was lower than that of control group， the difference was highly statistically significant （P < 0.01）. The level of NF-κB in disease group was higher than that of control group， the difference was highly statistically significant （P < 0.01）. In disease group， there was a positive linear correlation between TLR9 mRNA and NF-κB mRNA （r = 0.89， P < 0.01）. Conclusion Compared with normal people， the level of TLR9 mRNA in erythema nodosum patients is significantly decreased， while the level of NF-κB mRNA is significantly increased， suggesting that TLR9 and NF-κB may play an important role in the occurrence and development of erythema nodosum.

[Key words] Erythema nodosum； Peripheral blood； Toll-like receptor 9； Nuclear factor-κB

結节性红斑（erythema nodosum，EN）是临床常见的一种病因复杂并易反复发作的炎症性皮肤病，病理表现为间隔性脂膜炎，主要临床表现为双小腿伸侧疼痛性、对称性红色结节，结节为非溃疡性，可自行消退，青年女性好发[1]。EN确切的发病机制目前尚不明确，其发生可能是机体对某些病原微生物抗原的一种迟发型超敏反应，也可能是一种免疫复合物疾病[2]。人类Toll样受体（Toll-like receptor，TLR）是近年来发现的一类新的细胞表面信号传导跨膜受体，是人体固有免疫和适应性免疫的桥梁，是一种机体通过感知微生物病原体直接作出防御反应的天然免疫受体，TLR9是TLR家族的重要成员，能识别多种微生物的病原体相关分子模式（pathogen-associated molecular patterns，PAMP），通过刺激信号的级联反应诱导炎症介质和炎性细胞因子的产生，从而参与多种感染性疾病的进展[3]。核因子-κB（NF-κB）是一种重要的转录调控因子，在免疫应答中发挥重要作用，主要是通过与启动子及增强子的作用，从而促进多种免疫细胞及细胞因子的活化。……