妊娠过程中凋亡级联的作用和调节  

The Role and Regulation of the Apoptotic Cascade during Pregnancy

作　　者：罗锦花[1,2] 齐荣义[3] 田亚平[1] 

机构地区：[1]中国人民解放军总医院妇产科,北京100853 [2]天津南开大学医学院 [3]中国人民解放军第二五四医院妇产科

出　　处：《国际妇产科学杂志》2013年第3期198-202,共5页Journal of International Obstetrics and Gynecology

摘　　要：细胞凋亡是一种级联事件,在妊娠过程中发挥了重要的作用,主要体现在胎盘形成过程中滋养细胞层分化为合体细胞滋养层,滋养层入侵确保了胎盘锚固于母体血管系统以保证胎儿氧气及营养的供应。滋养层细胞的凋亡限制了子宫壁侵入,维持母体完整性,凋亡产生的多肽是胎儿特异性耐受建立的诱导物。整个级联过程受母体免疫系统的监控,妊娠妇女的免疫应答并没有显著降低,母体免疫系统能够识别胎儿移植物这个外源性抗原并作出应答。母胎界面特定的免疫耐受诱导机制使绒毛外滋养细胞(EVT)限制和容忍相互联系。细胞因子主要由自然杀伤细胞、T细胞分泌,白细胞通过细胞因子发挥其免疫调节作用。凋亡过程受到基因调控、激素及氧化应激等因素的影响。Apoptosis is a cascade of events played an important role during pregnancy,it plays crucial roles in cytotrophoblast differentiation into syncytiotrophoblast.Trophoblast invasion ensures the anchoring of the placenta within the uterine wall and the access of the fetus to the maternal vascular system to assure the supply of oxygen and nutrients.Apoptosis of EVT limits uterine invasion.Peptides from apoptotic EVT cells serve as inducers to establish a local tolerance during the 2nd trimester.The apoptotic cascade monitoried by the mother＇s immune system.The immune status of pregnant women is not sig nificantly reduced in comparison with that of non-pregnant women.Maternal immune system is able to recognize and react a gainst the foreign antigens of the ＂fetal transplant＂.A specific tolerance induction mechanism interconnects EVT limitation and tolerance at the feto-maternal interface.Cytokines are secreted predominantly by T-cells and NK cells,and Leukocytes exert their action through cytokines which resemble paracrine immune response modulators.Apoptotic process regulated by genes,hormones,and oxidative stress,etc.

关 键 词：细胞凋亡 妊娠 组织相容性 母体胎儿 免疫耐受 免疫学监视 细胞因子类 

分 类 号：R714[医药卫生—妇产科学]