Relationship between Toll-like receptor 2 on polymorphonuclear neutrophil and postoperative systemic inflammatory response syndrome in patients undergoing orthotopic liver transplantation

Objective To investigate the role of Toll-like receptor 2(TLR2)on polymorphonuclear neutrophil(PMN)during perioperative period in the development of postoperative systemic inflammatory response syndrome(SIRS)in patients undergoing orthotopic liver transplantation(OLT).Methods Twenty ASA Ⅲ or Ⅳ patients(NYHA Ⅱ or Ⅲ)of both sexes(18 male,2 female)aged 33-58 yr weighing 52-73 kg undergoing OLT were studied.Blood samples were collected from central vein for determination of TLR2 expression on PMN and plasma TNF-α,IL-1β and IL-8 concentrations before induction of anesthesia(T1,baseline),at 25 min of anhepatic phase(T2),3 h(T3)and 24 h after beginning of reperfusion of the allograft(T4).The expression of TLR2 was measured by flow cytometry and the serum concentrations of TNF-α,IL-β and IL-8 were measured by enzyme linked immuno-sorbant assay(ELISA).The patients were divided into SIRS and non-SIRS group depending on whether the patients developed SIPS or not within 7 days after operation. The diagnosis of SIRS was based on the criteria laid down by ACCP and SCCM in 1992.Results Ten patients developed SIRS within 7 days after operation.There was no significant difference in Child-Turcotte-Pugh(CTP)scores between the 2 groups.Compared with non-SIRS group,the TLR2 expression on PMN and the~rllm IL-1β concentration were significantly increased at T4,and the serum IL-8 concentration were significantly increased at T3 in SIRS group.There was positive correlation between serum TNF-α concentration and TLR2 expression on PMN in SIRS group(r=0.607,P＜0.05).Conclusion The expression of TLB2 on PMN increases significantly at 24 h after beginning of reperfusion of allograft and may play an important role in the development of postoperative SIRS. Key words: Sepsis syndrome; Neutrophils; Liver transplantation; Toll like receptors 2