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TLR2 and TLR4 gene expression levels and associated factors during acute attack and attack-free periods in familial Mediterranean fever.
[familial mediterranean fever]
The
purpose
of
this
clinical
study
was
to
determine
if
the
expression
of
the
TLR
2
and
/
or
TLR
4
genes
is
involved
in
triggering
the
auto-
inflammatory
attacks
in
patients
with
familial
Mediterranean
fever
(
FMF
)
.
Thirty
patients
with
FMF
and
20
healthy
control
subjects
were
recruited
.
Comparisons
were
made
in
TLR
2
and
TLR
4
gene
expression
levels
during
FMF
attack
episodes
and
attack-free
periods
,
as
well
as
with
baseline
levels
in
healthy
control
subjects
.
There
was
no
significant
difference
in
TLR
2
and
TLR
4
gene
expression
between
the
attacks
and
attack-free
periods
in
the
entire
group
of
FMF
patients
.
However
,
among
female
patients
,
expression
level
of
TLR
4
gene
was
significantly
higher
during
the
attack
than
in
the
attack-free
period
(
TLR
2
Log
2
.
04
 
±
 
0
.
14
vs
.
2
.
52
 
±
 
0
.
10
,
respectively
,
P
 
=
 
0
.
02
)
.
There
was
not
a
significant
difference
between
FMF
patients
and
healthy
subjects
.
The
patients
who
had
higher
levels
of
TLR
2
expression
during
the
acute
attack
experienced
their
first
attacks
at
an
earlier
age
(
r
 
=
 
-
0
.
571
;
P
 
=
 
0
.
001
)
.
The
frequency
of
attacks
,
acute
-phase
response
,
MEFV
mutations
,
and
colchicine
response
were
not
associated
with
TLR
2
and
TLR
4
levels
.
We
conclude
that
changes
in
the
expression
of
TLR
2
and
TLR
4
genes
do
not
appear
to
be
involved
in
triggering
FMF
attacks
.
A
higher
level
of
TLR
2
expression
during
acute
attack
may
be
related
to
the
early
onset
of
the
disease
.
Further
studies
using
specific
cell
populations
such
as
neutrophils
,
monocytes
,
and
dendritic
cells
may
be
useful
to
explore
any
changes
in
the
sensitivity
of
toll-like
receptors
to
their
agonists
,
such
as
lipopolysaccharides
,
in
the
onset
of
attacks
.
Diseases
Validation
Diseases presenting
"acute-phase response"
symptom
familial mediterranean fever
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