Medicine Department and Hematology Unit, Assiut University Hospitals
and South Egypt Cancer Institute Bone Marrow Transplantation Unit,
Assiut University, Assiut, Egypt.
2 Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt.
3 Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
* Both author equally contributed to the work.
| This is an Open Access article distributed
under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
fungal infections (IFIs) are important cause of mortality in acute
myeloid leukemia (AML) patients on treatment with intensive induction
chemotherapy. Toll-like receptors, mainly Toll-like receptors 2 and 4
(TLR2 and TLR4), play a considerable role in the host defense against
microorganisms. The involvement of TLR signaling in modulation of
innate immune response is extensively discussed, but the TLR
expressions proﬁling on adaptive immune cells are not specified. Also,
the expressions of TLRs and their association with the occurrence of
IFIs in patients with AML are not studied. So, the novel aim of this
study was to investigate the associations between the T-lymphocyte
expression of TLR2 and TLR4 and the occurrence of IFIs in AML patients
treated with intensive induction chemotherapy.
Results: There was a significant increase in the expression of TLR4 in AML patients with IFI compared to healthy controls (p=0.001).
TLR2 and TLR4 expressions increased significantly in AML patients with
mixed fungal and bacterial infection compared to healthy controls (p= 0.002 and p=0.001, respectively).
Materials and Methods
|Figure 1. Representative gating strategy used to detect the TLR2+ and TLR4+ T cells. Blood samples were stained with PerCP-conjugated anti-HLA-DR, APC-conjugated anti-CD3, Alexa fluor 488-conjugated anti-CD282 (TLR2), and PE-conjugated anti CD284 (TLR4). Lymphocytes were selected (R1) and then gated on CD3+ cells (R2) and HLA-DR+ cells (R3). R2 was further analyzed for TLR2 and TLR4 expression.|
|Table 1. Demographic and clinical characterization of the AML patients with IFI|
|Table 2. Identified fungal pathogens* among the 40 AML patients.|
|Table 3. TLR2 and TLR4 expression level in comparison between patients and control group.|
|Table 4. TLR2 and TLR4 expression level in comparison between AML patients with mixed fungal and bacterial infection and healthy controls.|