母-胎免疫调节机制在妊娠高血压综合征病理过程中的作用  

Effect of fetal-maternal immune tolerance on pregnancy-induced hypertension

作　　者：李丽娜[1] 徐振宇[2] 孔丽娜[1] 

机构地区：[1]皖南医学院弋矶山医院妇产科,芜湖241001 [2]皖南医学院弋矶山医院药剂科,芜湖241001

出　　处：《中国免疫学杂志》2017年第9期1398-1401,共4页Chinese Journal of Immunology

摘　　要：目的:分析妊娠高血压综合征(PIH)患者外周血中免疫细胞因子水平变化及滋养层细胞中免疫相关转录因子的基因、蛋白表达情况,探讨母-胎免疫调节机制在妊娠高血压综合征病理过程中的作用。方法:纳入PIH患者50例作为观察组,选择同期分娩的正常妊娠妇女40例作为对照组。ELISA法检测两组孕妇外周血中IFN-γ、IL-4、IL-17及TGF-β水平;实时荧光定量PCR(RT-q PCR)法和蛋白质印迹法(Western blot)分别测定两组孕妇胎盘滋养层细胞中转录因子T-bet、GATA-3、RORC、Foxp3的mRNA及蛋白表达情况。结果:(1)观察组外周血中IFN-γ和IL-17水平明显高于对照组,TGF-β水平明显低于对照组(P<0.05);两组间IL-4水平无明显差异(P>0.05);观察组IFN-γ/IL-4、IL-17/TGF-β比值均明显大于对照组(P<0.05)。(2)与对照组比,观察组T-bet、RORC的mRNA及蛋白表达水平均显著升高(P<0.05),而GATA-3、Foxp3的mRNA及蛋白表达水平均显著降低(P<0.05),T-bet/GATA-3及RORC/Foxp3比值均显著增大(P<0.05)。结论:PIH具有明显的Th1/Th2及Th17/Treg比例失衡现象,其病理机制可能与Th细胞介导的母-胎免疫耐受机制功能紊乱有关。Objective: To analyze the levels of immune cytokine in peripheral blood( PB) and the expressions of immune related transcription factors in placenta cytotrophoblast,which in patients with pregnancy-induced hypertension( PIH). And to explore the effect of fetal-maternal immune tolerance on pregnancy-induced hypertension. Methods: 50 cases patients with PIH were selected as the observation group,and 40 healthy people were chosen as the control group. Enzyme-linked immunoassay( ELISA) was performed to detect the levels of IFN-γ,IL-4,IL-17 and TGF-β in peripheral blood. Quantitative Real-time PCR( RT-q PCR) and Western blot were used to analyze the mRNA expressions and protein levels of T-bet,GATA-3,RORC and Foxp3 in placenta cytotrophoblast,respectively. Results:(1)Compared with the control group,the IFN-γ and IL-17 levels in peripheral blood in the observation group were obviously higher and the TGF-β level was greatly lower( P < 0. 05). There was no significant difference of IL-4 level between the two groups( P>0. 05),but the ratios of IFN-γ/IL-4 and IL-17/TGF-β in the observation group were larger than that in the control group( P<0. 05).(2)Compared with the control group,the mRNA expressios and protein levels of T-bet and RORC in the observation group were increased significantly( P<0. 05),but that of GATA-3 and Foxp3 were decreased greatly( P<0. 05). Thus,the ratios of T-bet/GATA-3 and RORC/Foxp3 in the observation group were significantly larger than that in the control group( P<0. 05). Conclusion: PIH is occurred with the imbalance of Th1/Th2 and Th17/Treg,and it might be associated with the mechanism of fetal-maternal immune tolerance disorder that induced by Th cells.

关 键 词：妊娠高血压综合征 母-胎免疫耐受 滋养层细胞 细胞因子 转录因子 

分 类 号：R714.2[医药卫生—妇产科学]