外周血及蜕膜组织中CD4^+ CD25^+调节性T细胞比例和炎症因子原因不明复发性流产的关系研究  

Relationship of ration of CD4^+ CD25^+ regulatory T cells in peripheral blood and decidua and inflammatory factors with unknown recurrent spontaneous abortion

作　　者：楼向明 刘文华 费小阳 

机构地区：[1]杭州市妇产科医院(杭州市妇幼保健院)妇女保健科,杭州310000

出　　处：《中国性科学》2016年第6期118-120,共3页Chinese Journal of Human Sexuality

摘　　要：目的:探究外周血及蜕膜组织中CD4^+CD25^+调节性T细胞比例以及相关炎症因子对原因不明复发性流产的影响。方法:选取2014年5月至2015年5月就诊于我院门诊的原因不明复发性流产(URSA)患者90例为观察组,并选取同期在妇产科门诊手术室的行人工流产手术的正常患者90例为对照组;分析两组患者的一般资料、外周血及蜕膜组织中CD4^+CD25^+调节性T细胞比例、调节性T细胞特异调节因子Foxp3和EBi3的表达以及血清炎症因子(包括TNF-α、IL-2、IL-6、IL-10)水平,研究其相关性。结果:与正常妊娠组相比,反复流产组外周血及蜕膜组织中Treg细胞比例明显降低,Foxp3和EBi3因子mRNA的表达水平明显降低,且无论URSA患者或者是正常对照组,蜕膜中各因子的表达均高于外周血中的表达,外周血TNF-α、IL-2水平明显升高,而IL-6和IL-10水平要明显降低,差异有统计学意义(P<0.05)。结论:蜕膜中各因子的表达均高于外周血中的表达提示妊娠过程的主要免疫反应部位是"母-胎界面",Treg细胞比例、Treg细胞因子和Th2型因子IL-6、IL-10水平可能参与妊娠的维持,调控"母-胎界面"局部免疫耐受。对于复发性流产的发病过程具有一定的影响作用。Objectives： To explore the ration of CD4-＋CD25-＋regulatory T cells in peripheral blood and decidua and the impact of inflammatory factors on recurrent miscarriages with unknown reasons. Methods： 90 patients of unknown recurrent miscarriage（ URSA） in our hospital from May 2014 to May 2015 were selected as the observation group,and 90 patients underwent induced abortion operation in the same period were chosen as the control group. The general information,CD4-＋CD25-＋regulatory T cells proportion in peripheral blood and decidua,regulatory T cell- specific regulatory factors and EBi3 Foxp3 expression and serum inflammatory cytokines（ including TNF- α,IL- 2,IL- 6,IL- 10） levels of the two groups were analyzed,to study the correlation. Results： Compared with normal pregnancy,the proportion of Treg cells in peripheral blood and decidua of recurrent miscarriage group was significantly decreased,and the expression level of Foxp3 mRNA EBi3 factor significantly reduced. For both URSA patients and normal control group,factor expression in decidua was higher than that in peripheral blood; the expression levels of TNF- α,IL- 2 were significantly increased,while IL- 6 and IL- 10 level was significantly lowered,with statistically significant difference（ P〈0. 05）. Conclusion： The expression of each factor in decidua being higher than the expression in peripheral blood during pregnancy indicates that a major part of the immune response is the ＂ mother- fetal interface＂. Treg cell percentage,Treg cytokines and Th2- type factor IL- 6,IL-10 levels may be involved in the maintenance of pregnancy and the local tolerance regulation of ＂ mother- fetal interface＂,which has a certain influence on the pathogenesis of recurrent miscarriage.

关 键 词：CD4+CD25+调节性T细胞 原因不明复发性流产 炎症因子 

分 类 号：R714.21[医药卫生—妇产科学]