Effect of ulinastatin on toll-like receptor 4 expression of peripheral blood monocytes in patients with severe acute pancreatitis

Objective: To investigate the effect of ulinastatin on toll-like receptor 4(TLR4) expression of peripheral blood monocytes in patients with severe acute pancreatitis(SAP).Methods: Fifty-eight patients with SAP were randomly divided into ulinastatin group(n=29) and routine group(n=29).Healthy volunteers were included as control group(n=20).Blood samples were collected by venipuncture on the day of admission and 3,5,7,14 day after admission.TLR4 and CD14 expressions on peripheral blood monocytes(PBMCs) were detected by flow cytometry.Plasma level of serum tumor necrosis factor alpha(TNF-α) and interleukin 6(IL-6) were measured by ELISA simutaneously.Correlations between these parameters were analyzed.Results: The expression of TLR4 was obviously up-regulated in ulinastatin group and routine group than that in control group on the day of admission(P0.01).On the day of 3,5 after admission,the expressions of TLR4 were continued to decline,but still were higher than those of control group(P0.05).The expression of TLR4 in ulinastatin group was lower than that of routine group on the day of 3,5,7 after admission(P0.05).The alteration of TNF-α and IL-6 were consistent with that of TLR4.Conclusions: The expression of TLR4 in PBMCs is up-regulated in patients with SAP.Ulinastatin can down-regulate the expression of TLR4 in PBMCs and inhibit the inflammation reaction to educe protective effect on patients with SAP.