The role of Toll-like receptors-4 in the pathogenesis of development of anemia of inflammation in young children
DOI:
https://doi.org/10.14739/2310-1237.2020.1.203642Keywords:
anemia of inflammation, Toll-like receptors-4, young childrenAbstract
Aim. To determine the pathogenetic role of Toll-like receptors-4 (TLRs-4) in the development of anemia of inflammation (AI).
Materials and methods. The content of TLRs-4, ferritin and iron in blood serum of 78 children (1.5 ± 0.4 years old on the average) was studied by enzyme-linked immunosorbent assay. The main group included 46 children with acute inflammatory bacterial diseases of the respiratory system, which were divided into 2 subgroups: the first subgroup included 24 children with AI, the second – 22 children without anemia. Depending on the etiological factor, the main group was divided into subgroups: 1a – 12 patients with AI, Streptococcus pneumoniae was detected as the pathogen, 1b – 12 patients with AI, the pathogen – Haemophilus influenzae, 2a – 11 patients without AI, the pathogen – Streptococcus pneumoniae, 2b – 11 patients without AI, the pathogen – Haemophilus influenzae. The comparison group included 16 children with iron deficiency anemia without inflammatory manifestations. Control group included 16 conditionally healthy children. The observation groups were representative by age and sex of the children.
Results. It was determined that the content of TLRs-4 in children in the main group depended on the bacterial pathogen. The content of TLRs-4 in the subgroup where Haemophilus influenzae was the etiological factor exceeded more than 2 times the results of the control group (P < 0.05), 1.7 times the comparison group, and 2 times relative to their content in the group, where the disease was caused by Streptococcus pneumoniae (P < 0.05). There was a close correlation between the content of TLRs-4 in the group of patients whose disease was caused by gram-negative flora and the content of ferritin (r = 0.8, P < 0.05). The iron in the blood serum of children with anemia of inflammation was significantly lower than in the comparison and control groups by 1.6 times (8.78 (6.8215.30) ng/ml and 13.88 (12.74–16.52) ng/ml, respectively, P < 0.05).
Conclusions. The development of AI in young children is accompanied by an increase in TLRs-4, primarily in response to the intrusion of gram-negative microflora (Haemophilus influenzae). The content of ferritin is directly dependent on their level, which suggests the starting role in the protective mechanism of iron sequestration, which is an important link in the pathogenesis of the development of AI.
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