Using of TLR2 and TLR4 as Biomarker of Sepsis Severity Detection

Abstract

Sepsis syndrome is a complicated clinical dysfunction, which caused by a systemic inflammatory response to bacteria and/or their products .The quantitative real-time PCR technique has been used for measure TLR2 and TLR4 gene expression in whole blood, and ELISA technique has been used for detection of cytokines TNF-α, IL-10 and soluble HLA-DR from 75 septic syndrome cases (nineteen of patients showed symptoms of systemic inflammatory response syndrome (SIRS); twenty eight patients have sepsis, seventeen patients suffered from severe sepsis and eleven patients have septic shock) and 55 healthy controls (HC). TLR2 and TLR4 mRNA expression was high and significant in the all patients (P< 0.05). TNF-α, IL-10 and sHLA-DR serum levels were significantly elevated in the serum of patients group with septic syndrome compared with controls (P<0.05). However, the level of HLA-DR in SIRS patients was non-significant in comparing with healthy control group. Furthermore, TLR2 and TLR4 showed that there are significant differences between the severity stages of sepsis. The correlation between TLR 4 with concentration of sHLA-DR was significant and positive. The results of a recent study conclude that the possibility of using TLR 2 and TLR 4expression to determine the severity of sepsis as diagnostic biomarker.

Novel Diagnostics and Therapeutics in Sepsis

“…The discovery of TLRs in humans, and the early recognition of TLR-4 as the receptor that signals LPS bioactivity were major breakthroughs not only in the field of immunology but also in sepsis [ 52 ]. Despite a lack of larger studies demonstrating an association between TLR4 and biomarkers like PCT and CRP in diagnosis of sepsis, results of a recent study conclude the possibility of using TLR2 and TLR4 expression to determine the severity of sepsis as a diagnostic biomarker ( p < 0.05) [ 53 ]. Additionally, some data support a link between TLR4 signaling and pathological inflammation during infection by SARS-CoV-2, the virus causing the disease Covid-19 [ 54 ].…”