Changes and significance of TLR3, TLR4, TNF-α and IL-10 expressions after PCI in patients with coronary heart disease and diabetes mellitus

Wu Jun; Wen Yahong; Tang Yongjiang

doi:10.3969/j.issn.1674-4055.2018.04.29

Abstract：Objective To investigate the changes and significance of TLR3, TLR4, TNF-α and IL-10 expressions after PCI in patients with coronary heart disease and type-2 diabetes mellitus. Method 90 patients with stable coronary heart disease from March 2014 to April 2016 were divided them into T2DM group (39 patients) and non T2DM group (59 patients) according to whether the patients had type 2 diabetes mellitus (T2DM). All patients underwent percutaneous coronary intervention (PCI) treatment successfully. The patients' peripheral blood were sampled at preoperative, postoperative 24h, postoperative 7d and postoperative 30d, respectively. TLR3, TLR4 and mRNA protein expression levels of peripheral blood mononuclear cells were measured using real-time fluorescence quantitative PCR (qRT-PCR) and western blot (WB) assay. Serum IL-10, TNF-α expression levels were measured using enzyme linked immunosorbent assay (ELISA) method. Correlation analysis was carried out by Pearson method. The incidence of major adverse events after PCI was analyzed, and the factors that affected the postoperative adverse events were analyzed by multiple factor logistic regression. Results The levels of TLR3mRNA and protein in T2DM group were significantly lower than those in non T2DM group, and the levels of TLR4mRNA and protein were significantly higher than those in non T2DM group, the difference was statistically significant (P<0.05). After PCI, the levels of TLR3mRNA and protein in two groups were significantly increased, and the levels of TLR4mRNA and protein were significantly decreased (P<0.05). Compared with non T2DM group, the level of IL10 in T2DM group was significantly lower, and the level of TNF-α was significantly higher (P<0.05). After PCI, the IL10 levels in two groups were significantly increased, TNF-α levels were decreased significantly. The results of follow-up showed that the total incidence of major adverse cardiac events in the T2DM group was significantly higher than that in the non DM group (P<0.05). Result of multivariate logistics regression analysis showed that the factors influencing adverse cardiac events after PCI were blood glucose, number of lesions, and IL-10, TLR3 and TLR4 (OR=2.645, 3.421, 2.854, 3.682, 4.157, P=0.035, 0.016, 0.017, 0.031, 0.001). Conclusion TLR3 and IL-10 are significantly lower in patients with coronary heart disease and diabetes mellitus after PCI. TLR4 and TNF-alpha are highly expressed. The incidence of major adverse cardiac events after PCI is high. TLR3, IL-10 and TLR4 are the main factors that influence the prognosis of patients with coronary heart disease combined with diabetes mellitus.