Objective To analyze the correlation between the ghrelin level and Toll-like receptor (TLR) 4 signal pathway in children with hand, foot, and mouth disease (HFMD), and to explore the mechanism of ghrelin in the inflammatory immune response of HFMD. Methods The clinical data of 100 children with HFMD were retrospectively analyzed, they were divided into a mild group (n=65) or a severe group (n=35) according to their severity, and 100 healthy children were selected as the control group (n=100). The ghrelin level, as well as the positive expression rate and the mean fluorescence intensity (MFI) of TLR4, was compared between the three groups, and the correlations of the ghrelin level with the positive expression rate and the MFI of TLR4 were explored by linear correlation analysis. Results There were statistically significant differences in the ghrelin level, positive expression rate of TLR4, and MFI of TLR4 between the three groups (all P<0.05). The ghrelin levels of the control group, the mild group, and the severe group decreased successively, while the positive expression rate and MFI of TLR4 of the severe group, the mild group, and the control group decreased successively (all P<0.05). The linear correlation analyses results showed that the ghrelin level was negatively correlated with the positive expression rate of TLR4 (r=-0.729) and the MFI of TLR4 (r=-0.697) in children with HFMD (all P<0.05). Conclusion In children with HFMD, the ghrelin level decreased, the positive expression rate and the MFI of TLR4 increased, and the ghrelin level was negatively correlated with the positive expression rate and the MFI of TLR4. Ghrelin may play a protective role in the inflammatory immune response in the pathogenesis of HFMD, with an inhibition effect on the TLR4 signal pathway.

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