Sporadic acute Stanford type A aortic dissection (TAAD) is a serious condition that requires urgent treatment to avoid catastrophic consequences. The purpose of the present study was to explore, firstly, whether TLR4-regulated immune signalling molecules were activated in TAAD patients and, secondly, whether TLR4-regulated inflammatory products interleukin-1β (IL-1β) and CC chemokine ligand 5 (CCL5) could be a promising biomarker for diagnosis in patients with TAAD. Full-thickness ascending aortic wall specimens from TAAD patients (n = 12) and control donors (n = 12) were examined for the expression of TLR4 and its major signalling molecules, in terms of immunity and inflammation. Blood samples from TAAD (n = 49) and control patients (n = 53) were collected to detect the circulating plasma cytokine levels of IL-1β and CCL5. We demonstrated that expression levels of TLR4 and its downstream signalling cascade molecules were significantly elevated. Furthermore, receiver operating characteristic curve analyses showed that elevated IL-1β levels and decreased plasma CCL5 may have diagnostic value for TAAD. In summary, this current study suggests a more generalized pattern of inflammation in TAAD. In addition, TLR4-mediated inflammatory product, such as IL-1β and CCL5, could be novel and promising biomarkers with important diagnostic and predictive value in the identification of sporadic TAAD diseases.

中文翻译：

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TLR4 的表达在散发性急性 Stanford A 型主动脉夹层患者中上调

散发性急性斯坦福 A 型主动脉夹层 (TAAD) 是一种严重的疾病，需要紧急治疗以避免灾难性后果。本研究的目的是首先探讨 TLR4 调节的免疫信号分子是否在 TAAD 患者中被激活，其次，TLR4 调节的炎症产物白介素-1 β (IL-1 β) 和 CC 趋化因子配体5 ( CCL5) 可能是诊断 TAAD 患者的一种有前途的生物标志物。 从免疫和炎症方面检查来自 TAAD 患者（ n  = 12）和对照供体（n = 12）的全层升主动脉壁标本的 TLR4 及其主要信号分子的表达。来自 TAAD 的血液样本 ( n = 49) 和对照患者 ( n = 53) 被收集以检测 IL-1 β和 CCL5 的循环血浆细胞因子水平。我们证明了 TLR4 及其下游信号级联分子的表达水平显着升高。此外，接受者操作特征曲线分析表明，升高的 IL-1β水平和降低的血浆 CCL5 可能对 TAAD 具有诊断价值。总之，目前的这项研究表明 TAAD 中存在更普遍的炎症模式。此外，TLR4 介导的炎症产物，如 IL-1β和CCL5，可能是新颖且有前途的生物标志物，在散发性 TAAD 疾病的鉴定中具有重要的诊断和预测价值。