淋巴细胞皮内注射对不明原因复发性流产患者外周血自然杀伤细胞的影响  

Impact of lymphocyte intradermal injection on peripheral blood NK cell in women with unexplained recurrent miscarriage

作　　者：梁佩燕 陈现 李观贵 刁梁辉 黄春宇 刘翠翠 曾勇 

机构地区：[1]深圳中山泌尿外科医院生殖医学中心 [2]深圳市围着床期生殖免疫重点实验室 [3]深圳中山生殖与遗传研究所,深圳518045

出　　处：《生殖医学杂志》2013年第6期394-399,共6页Journal of Reproductive Medicine

基　　金：广东省医学科学技术研究基金资助(B2012331)

摘　　要：目的探讨淋巴细胞皮内注射对不明原因复发性流产(recurrent miscarriage,RM)患者外周血自然杀伤(NK)细胞的影响。方法对71例不明原因RM患者进行淋巴细胞皮内注射治疗,采用流式细胞术检测RM患者治疗前和第三次治疗后黄体中期外周血NK细胞毒性和NK细胞数量及其亚群比例。结果分别在效应细胞与靶细胞(effector cell:targetcell,E:T)三个不同比例条件下对不明原因RM患者进行NK细胞毒性检测,淋巴细胞皮内注射治疗前后的结果对比为:50:1(E:T)为51.1%vs.40.9%(P=0.000)、25:1(E:T)为45.3%vs.36.1%(P=0.000)、12.5:1(E:T)为31.9%vs.25.6%(P=0.002),结果均显示治疗后NK细胞毒性显著降低;CD3^-CD56+NK细胞占外周血淋巴细胞比例(15.7%)较治疗前(17.3%)显著降低(P=0.003),其中CD56^(dim)CD16^+NK细胞亚群占总NK细胞的比例较治疗前显著降低(87.4%vs.89.3%,P=0.002),而CD56^(bright)CD16^-NK细胞比例(3.7%vs.3.8%)和CD69^+NK细胞比例(3.1%vs.2.9%)在治疗前后无显著变化(P>0.05)。治疗前后外周血三个不同比例的NK细胞毒性的变化与CD3^-CD56^+NK细胞数量、CD56^(dim)CD16^+以及CD69^+NK细胞亚群比例的变化均无显著相关性(P>0.05)。结论淋巴细胞皮内注射对不明原因RM患者外周血NK细胞毒性和比例具有显著下调作用,这可能有利于母体对妊娠免疫耐受的维持;NK细胞毒性和数量是评估不明原因RM患者NK细胞功能的两个独立指标。Objective： To investigate the impact of lymphocyte intradermal injection on peripheral blood natural killer（NK）cells in patients with recurrent miscarriage. Methods. A total of 71 unexplained recurrent miscarriage patients received lymphocyte intradermal injection. The percentage, subset and cell cytotoxicity of NK cell in peripheral blood of the patients in the luteal phase were assessed by flow cytometry prior to treatment and after the third treatment. Results： NK cell cytotoxieity was measured at effeetor-to-target cell（E： T）ratios of 50： 1,25：1 and 12.5： 1 before and after lymphocyte intradermal injection in patients with unexplained recurrent miscarriage. The NK cell cytotoxicity was significantly decreased after treatment at ratio of 50：1 （51.1% vs. 40.9%,P=0. 000）,25：1（45.3% vs. 36.1%,P=0.000）and 12.5.1（31.9% vs. 25.6%,P=0. 002）, respectively. The percentage of CD3 CD56＋ NK cell in the peripheral blood lymphocytes was significantly decreased（15.70% vs. 17.3% ,P=0. 003）,and the percentage of CD56^dim CD16^＋ NK cell subset in the total NK cells was significantly decreased compared with before treatment（87.4% vs. 89.3% ,P=0. 002）. There was no significant difference in the percentages of CD56bright CD16 NK cell（3.8% vs. 3.7%）and CD69^＋ NK cell（2.9 % vs. 3.1% ;,before and after treatment. The change of NK cell cytotoxicity at different E：T ratios showed no significantly correlation with the change of percentages of CD3 CD56^＋ NK cell and CD56^dim CD16^＋ and CD69^＋ NK cell subsets before and after treatment（P〉0.05）. Conclusions. Lymphocyte intradermal injection can significantly down-regulate the NK cells percentage and NK cell cytotoxicity, which may be beneficial for the maintenance of immunological tolerance during the pregnancy. The percentage of NK cell and NK cell cytotoxicity represent two independent parameters in evaluating the function of NK cell of patients with unexplained recurrent miscarriage.

关 键 词：自然杀伤细胞 淋巴细胞皮内注射 复发性流产 

分 类 号：R32[医药卫生—人体解剖和组织胚胎学]