TLR2/TLR4 inflammatory signaling pathway of pulmonary infection in patients with type 2 diabetes mellitus and its risk factors
OBJECTIVE To explore the Toll-like receptor(TLR)2/TLR4 inflammatory signaling pathway of pul-monary infection and its risk factors in patients with type 2 diabetes mellitus.METHODS The clinical data of 168 patients with type 2 diabetes admitted to Sichuan People's Hospital from Jan.2021 to Jan.2023 were retrospec-tively analyzed,and they were divided into the infected group(n=33)and the non-infected group(n=135)ac-cording to the pulmonary infection of patients with type 2 diabetes mellitus.The pathogenic bacteria of pulmonary infection in patients with type 2 diabetes mellitus were counted,the risk factors of pulmonary infection in patients with type 2 diabetes mellitus were summarized,and the expression of TLR2 and TLR4 in peripheral blood mono-nuclear cells(PBMC)of the two groups were compared.RESULTS A total of 48 strains of pathogenic bacteria were co-cultured and isolated from 33 patients with type 2 diabetes mellitus and lung infections,of which 29 strains of gram-negative bacteria accounted for 60.42％,14 strains of gram-positive bacteria accounted for 29.17％and 5 strains of fungi accounted for 10.42％,with Escherichia coli and Klebsiella pneumoniae being the main pathogens.The duration of disease,pulmonary complications and time of hospitalization were the risk fac-tors of pulmonary infection in patients with type 2 diabetes mellitus(P＜0.05).The levels of TLR2 mRNA and TLR4 mRNA in PBMC in non-infected group were lower than those in infected group(P＜0.001).CONCLUSION The main pathogenic bacteria of pulmonary infection in type 2 diabetes mellitus were gram-negative bacteria.The duration of disease,pulmonary complications and time of hospitalization were the risk factors of pul-monary infection in type 2 diabetes patients.TLR2 and TLR4 were highly expressed in PBMC of type 2 diabetes mellitus patients with pulmonary infection,which could be used for early targeted prevention and treatment to re-duce the risk of pulmonary infection in patients with type 2 diabetes mellitus.
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