人巨细胞病毒感染与不明原因反复胚胎种植失败患者Th1/Th2、Th17/Treg型细胞因子表达水平的关系  

Relationship between human cytomegalovirus infection and the expression levels of Th1/Th2 and Th17/Treg cytokines in patients with unexplained recurrent implantation failure

作　　者：蒋伟民 李林江 孙少青 赵星 江欣星 JIANG Wei-min;LI Lin-jiang;SUN Shao-qing;ZHAO Xing;JIANG Xin-xing(Hainan Modern Women and Children's Hospital,Haikou,Hainan 571100,China;不详)

机构地区：[1]海南现代妇女儿童医院生殖医学科,海南海口571100 [2]海南医学院第一附属医院生殖医学中心,海南海口570100

出　　处：《中华医院感染学杂志》2021年第15期2367-2371,共5页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(201985652)。

摘　　要：目的探讨人巨细胞病毒(HCMV)感染与不明原因反复胚胎种植失败(RIF)患者辅助性T细胞(Th)1/Th2、Th17/调节性T细胞(Treg)型细胞因子表达水平的关系。方法选择2018年1月-2020年1月海南现代妇女儿童医院生殖医学科收治接受IVF-ET助孕的不明原因RIF患者100例作为RIF组,均采用酶联免疫试验法测定HCMV-IgM、HCMV-IgG抗体情况,实时荧光定量聚合酶链反应法(RT-PCR)测定外周血单个核细胞Th17、Treg相关细胞因子ROR-γt、Foxp3 mRNA表达,采血应用酶联免疫法测定白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、干扰素-γ(IFN-γ)和转化生长因子-β1(TGF-β1)水平,计算IFN-γ/IL-10、IL-17/TGF-β1比值,与同期收治移植后成功妊娠女性30例(成功组)进行对照,比较两组上述参数的差别;RIF组按是否发生HCMV感染分为感染组与非感染组,比较感染组与非感染组Th1/Th2、Th17/Treg型细胞因子表达水平的差异,探究HCMV感染与RIF患者Th1/Th2、Th17/Treg型细胞因子表达水平的关系。结果RIF组HCMV阳性率29.00%高于成功组3.33%(P<0.05);RIF组外周血单个核细胞ROR-γt高于成功组,血IL-17、IFN-γ、IFN-γ/IL-10比值、IL-17/TGF-β1比值高于成功组(P<0.05),Foxp3 mRNA及TGF-β1低于成功组(P<0.05);感染组ROR-γt mRNA、IL-17、IFN-γ、IFN-γ/IL-10比值、IL-17/TGF-β1比值高于非感染组(P<0.05),Foxp3 mRNA、IL-10和TGF-β1低于非感染组(P<0.05);HCMV阳性率与Th1/Th2、Th17/Treg均呈正相关(r=0.595、0.640,P<0.05)。结论不明原因RIF患者HCMV活动性感染率较高,伴HCMV感染患者Th1/Th2、Th17/Treg比值更高,向Th1、Th17免疫漂移更明显,整体免疫抑制程度更高,可能是造成胚胎移植排斥的重要原因。OBJECTIVE To explore the relationship between human cytomegalovirus(HCMV)infection and expression levels of helper T cells(Th)1/Th2 and Th17/regulatory T cells(Treg)cytokines in patients with unexplained recurrent implantation failure(RIF).METHODS A total of 100 patients with unexplained RIF who underwent IVF-ET in the Department of Reproductive Medicine of Hainan Modern Women and Children’s Hospital between Jan 2018 and Jan 2020 were recruited and divided into the RIF group.HCMV-IgM and HCMV-IgG antibodies were detected by enzyme-linked immunosorbent assay(ELISA).The mRNA expression of Th17,Treg-related cytokines(ROR-γt and Foxp3)in peripheral blood mononuclear cells(PBMC)were detected by real-time fluorescence quantitative polymerase chain reaction(RT-PCR).Blood was collected to detect levels of interleukin-17(IL-17),interleukin-10(IL-10),interferon-γ(IFN-γ)and transforming growth factor-β1(TGF-β1)by ELISA;the ratios of IFN-γ/IL-10 and IL-17/TGF-β1 were calculated,which were compared with those in 30 pregnant women with successful implantation named the success group.According to the presence or absence of HCMV infection,patients in the RIF group were divided into the infection group and non-infection group.The expression levels of Th1/Th2 and Th17/Treg cytokines were compared between the two groups.The relationship between HCMV infection and expression levels of Th1/Th2 and Th17/Treg in RIF patients was explored.RESULTS The positive rate of HCMV in the RIF group was 29.00%,significantly higher than that of 3.33%in the successful group(P<0.05).ROR-γt in peripheral blood mononuclear cells(PBMC)and the ratio of IL-17,IFN-γ,IFN-γ/IL-10 and IL-17/TGF-β1 in the RIF group were significantly higher than those in the successful group(P<0.05),while levels of Foxp3 mRNA and TGF-β1 were significantly lower than those in the success group(P<0.05).ROR-γt mRNA,IL-17,IFN-γ,IFN-γ/IL-10 and IL-17/TGF-β1 levels in the infection group were significantly higher than those in the non-infection group(P<0.05),while

关 键 词：不明原因 反复胚胎种植失败 辅助性T细胞 调节性T细胞 人类巨细胞病毒感染 

分 类 号：R321.33[医药卫生—人体解剖和组织胚胎学]