主动免疫治疗对原因不明性复发性流产患者Treg/Th17免疫平衡的影响  

Effects of active immunotherapy on Treg/Th17 balance in patients with unexplained recurrent spontaneous abortion

作　　者：张维平[1] 王文文 张调平 王奋勤[1] ZHANG Weiping;WANG Wenwen;ZHANG Tiaoping;WANG Fenqin(Department of Obstetrics and Gynecology,First People's Hospital of Tianshui City,Tianshui Gansu 741000,China)

机构地区：[1]甘肃省天水市第一人民医院妇产科,741000 [2]甘肃省肿瘤医院呼吸肿瘤内科 [3]甘肃省武山县中医院手术室

出　　处：《中国妇产科临床杂志》2021年第3期249-251,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：甘肃省天水市科技支撑计划项目(2019-SHFZKJK-6661)。

摘　　要：目的探究主动免疫治疗对原因不明性复发性流产(unexplained recurrentspontaneous abortion, URSA)患者调节性T细胞(T regulatory cells, Treg)/辅助性T淋巴细胞17(Helper T lymphocytes 17, Th17)免疫平衡的影响。方法 95例URSA根据治疗方式分为主动免疫组(n=51)与非免疫组(n=44),比较两组封闭抗体转阳率、外周血Treg、Th17细胞比率及免疫指标和妊娠结局。结果妊娠12周,主动免疫组Treg细胞比率、Treg/Th17比值高于非免疫组,Th17细胞比例低于非免疫组(P <0.05),免疫球蛋白G(immunoglobulin G, IgG)、免疫球蛋白M(immunoglobulin M, IgM)低于非免疫组(P <0.05),白介素(interleukin)-10、IL-4、IL-35、叉头框螺旋转录因子P3(forkhead box P3,Foxp3)m RNA高于非免疫组,IL-17、维甲酸相关孤核受体γt(retinoic acid-related orphan receptorγt,ROR-γt)低于非免疫组(P <0.05);主动免疫组封闭抗体阳性率、保胎成功率、足月分娩率高于非免疫组(P <0.05)。结论主动免疫治疗可调节URSA患者Treg/Th17细胞平衡,维持母胎免疫耐受,改善妊娠结局。Objective To explore the effect of active immunotherapy on regulatory T cells(Treg)/helper T lymphocytes 17(Th17) balance in patients with unexplained recurrent spontaneous abortion(URSA).Methods 95 patients with URSA were divided into active immunization group(n=51) and non-immunization group(n=44) according to the treatment method.The negative conversion rate of blocking antibody, ratios of peripheral blood Treg and Th17, immune indexes, and pregnancy outcomes were compared between the two groups.Results At gestational age of 12 weeks, the ratio of Treg cells and Treg/Th17 ratio in active immunization group were higher than those in non-immunization group, while ratio of Th17 cells was lower than the non-immunization group(P < 0.05).The immunoglobulin G(IgG) and Immunoglobulin M(IgM) were lower than those in the non-immunization group(P < 0.05).Interleukin(IL)-10, IL-4, IL-35 and forkhead box P3(Foxp3) mRNA were higher, while IL-17 and retinoic acid-related orphan receptor γt(ROR-γt) were lower than those in the non-immunization group(P < 0.05).The positive rate of blocking antibody, success rate of fetus protection and full-term delivery rate in the active immunization group were higher(P < 0.05).Conclusion Active immunotherapy can adjust Treg/Th17 balance in URSA patients, maintain maternalfetal immune tolerance, and improve pregnancy outcomes.

关 键 词：复发性流产 原因不明 主动免疫 妊娠 辅助性T淋巴细胞 调节性T细胞 

分 类 号：R714.21[医药卫生—妇产科学]