低剂量米非司酮对植入窗口期子宫内膜中子宫自然杀伤细胞数量及其亚型含量的影响  

Effects of low dose mifepristone on population and subsets of natural killer cells in human endometrium during receptive phase

作　　者：祝红霞[1] 张武文[1] 黄丽丽[1] 

机构地区：[1]浙江大学医学院附属妇产科医院计划生育科,杭州310006

出　　处：《中华妇产科杂志》2007年第12期826-829,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨低剂量米非司酮对植入窗口期子宫内膜中子宫自然杀伤(uNK)细胞数量及其亚型含量的影响。方法收集正常妇女植入窗口期的子宫内膜14份,将每份内膜组织平均分为3部分,分别用浓度为65 nmol/L 米非司酮(A 组)、200 nmol/L 米非司酮(B 组)和0 nmol/L 米非司酮(对照组)进行体外培养,运用免疫组化和流式细胞技术检测 uNK 细胞数量及 CD_3^-CD_(56)^+CD_(16)^-亚型、CD_3^-CD_(56)^+CD_(16)^+亚型的百分含量。结果 (1)A、B 及对照组子宫内膜中 CD_(56)^+uNK 细胞数量分别为(148±11)、(150±12)和(121±7)个,A、B 组分别与对照组比较,差异均有统计学意义(P<0.05);A、B 组之间比较,差异无统计学意义(P>0.05)。(2)A 组和 B 组子宫内膜中 CD_3^-CD_(56)^+亚型百分含量分别为(44±5)%和(48±4)%,高于对照组[(35±3)%],差异有统计学意义(P<0.05),A、B 组间比较,差异无统计学意义(P>0.05);A 组和 B 组子宫内膜 CD_3^-CD_(56)^+CD_(16)^-亚型百分含量分别为(42±5)%和(45±5)%,高于对照组[(33±3)%],差异有统计学意义(P<0.05),A、B 组间比较,差异无统计学意义(P>0.05);CD_3^-CD_(56)^+CD_(16)^+亚型百分含量分别为(2.70±0.24)%、(3.26±0.37)%和(2.33±0.29)%,3组间比较,差异无统计学意义(P>0.05)。结论低剂量米非司酮可通过增加uNK 细胞数量及 CD_3^-CD_(56)^+CD_(16)^-亚型百分含量,使植入窗口期子宫内膜局部免疫微环境失平衡,从而可能导致胚胎植入的失败。Objective To investigate the immunologic mechanism of low dose mifepristone as an anti-implantation contraceptive drug. Methods Endometrial biopsies were obtained from fourteen normally cycling women during the receptive phase. Each endometrial tissue, divided into three equal parts, was assigned to three groups： control group, 65 nmol/L mifepristone group （group A ） and 200 nmol/L mifepristone group （group B）. Endometrial explants were cultured in vitro. The numbers of natural killer cells and the percentages of CD3^-CD56^＋CD16^- subset and CD3^-CD56^＋CD16^＋ subset were analysed by immunohistochemistry and flow cytometry. Results （ 1 ） The mean number of CD56^＋ NK cells in group A （148 ± 11 ） and group B（ 150 ± 12） were significantly higher when compared to the control group（ 121 ±7, P 〈 0. 05 ）. There was no significant difference between the two mifepristone-treated groups （ P 〉 0. 05 ）. （2） The percentage of CD3^-CD56^＋ NK cells in group A （44 ± 5 ）% and in group B （48 ± 4 ）% were significantly higher when compared to the control group （35 ± 3 ） % , （ P 〈 0. 05 ） , there was no significantly difference between the two mifepristone-treated groups （ P 〉 0. 05 ） ; The percentage of CD3^-CD56^＋CD16^- subset in group A （42 ±5）% and in group B（45 ± 5）% were significantly higher when compared to the control group （33 ± 3 ） % , （ P 〈 0. 05 ）, there was no significantly difference between the two mifepristone-treated groups （ P 〉 0. 05 ） ; the percentages of CD3^-CD56^＋CD16^＋ subset in three groups [ （ 2.70 ± 0. 24 ） %, （ 3. 26 ± 0. 37 ） % and （2. 33 ± 0.29）% ] were not significantly different （P 〉 0. 05） . Conclusion Low dose mifepristones increase the number of CD56^＋ NK cells and the percentage of CD3^-CD56^＋CD16^- NK subset, which might result in the disturbance of human endometrial immuno-microenvironment during receptive phase and lead to implantation failure.

关 键 词：米非司酮 胚胎植入 子宫内膜 免疫耐受 杀伤细胞 天然 

分 类 号：R96[医药卫生—药理学]