Correlation between the expression of TLR9,MyD88,and related cytokines with prognosis and recurrence in children with oral herpes simplex virus type 1 infection

XU Feng-ling; LYU Jiang-feng; QIN Shuang; LIU Yu-tian; REN Yu-guo

doi:10.13820/j.cnki.gdyx.20243159

Abstract：Objective To explore the correlation between the expression of Toll-like receptor 9(TLR9),mye-loid differentiation factor 88(MyD88),and related cytokines with the prognosis and recurrence of oral herpes simplex vi-rus type 1(HSV-1)infection in children.Methods A total of 170 children with oral HSV-1 infection treated at the Affiliated People's Hospital of Shandong First Medical University between January 2021 and June 2024 were enrolled.Based on whether they experienced recurrent infections during follow-up,the children were divided into a recurrence group and a non-recurrence group.Real-time fluorescent quantitative PCR was used to measure the mRNA expression levels of TLR9 and MyD88 in peripheral blood,and magnetic particle chemiluminescence was used to detect serum inter-leukin(IL)-6 and IL-10 levels.Logistic regression analysis was performed to identify the risk factors for recurrent oral HSV-1 infection in children.Pearson correlation analysis was used to evaluate the correlation between TLR9,MyD88,and related cytokines with the prognosis and recurrence of oral HSV-1 infection in children.Results Of the 170 chil-dren,58 had recurrent oral HSV-1 infection and were included in the recurrence group,while the remaining 112 had no recurrence and were included in the non-recurrence group.The recurrence group had significantly higher levels of TLR9 and MyD88 mRNA,as well as TLR9/MyD88 co-expression,compared to the non-recurrence group:[(95.75±5.47)％vs.(52.47±3.71)％,(70.59±4.32)％vs.(29.17±1.73)％,and(71.53±5.75)％vs.(16.24±1.77)％](P＜0.05).Additionally,the recurrence group had significantly higher serum IL-6 and IL-10 levels than the non-recurrence group:[(82.16±6.47)pg/mL vs.(38.51±4.29)pg/mL,(6.37±0.94)pg/mL vs.(2.05±0.43)pg/mL](P＜0.05).There were significant differences between the two groups regarding immunodeficiency,defi-ciency of trace elements/vitamins,close contact with infection sources,TLR9,MyD88,IL-6,and IL-10 levels(P＜0.05).Logistic regression analysis showed that immunodeficiency,deficiency of trace elements/vitamins,close contact with infection sources,TLR9,MyD88,IL-6,and IL-10 were significant risk factors for recurrent oral HSV-1 infec-tion in children(P＜0.05).Pearson correlation analysis indicated that TLR9,MyD88,IL-6,and IL-10 were all posi-tively correlated with recurrence in oral HSV-1 infection in children(r=0.859 1,0.856 7,0.837 1,0.826 5,P＜0.001).Conclusion The levels of TLR9,MyD88,IL-6,and IL-10 are significantly elevated in children with recur-rent oral HSV-1 infection.The TLR/MyD88 signaling pathway may play an important role in the mechanism of prognosis and recurrence of oral HSV-1 infection in children.