生殖道感染对GDM孕妇胎盘中PI3K、AKT、FasL表达和胎膜早破的影响  

Effects of reproductive tract infection on PI3K,AKT and FasL expression and premature rupture of membrane in pregnant women with GDM

作　　者：赵方[1] 肖波[1] 张远远 方娟 吴利荣[1] ZHAO Fang;XIAO Bo;ZHANG Yuan-yuan;FANG Juan;WU Li-rong(Hanyang Hospital Affiliated to Wuhan University of Science and Technology,Wuhan,Hubei 430050,China)

机构地区：[1]武汉科技大学附属汉阳医院产科,湖北武汉430050

出　　处：《中华医院感染学杂志》2023年第15期2348-2352,共5页Chinese Journal of Nosocomiology

基　　金：湖北省科研基金资助项目(2019L02100)。

摘　　要：目的 探究生殖道感染对妊娠糖尿病(GDM)孕妇胎盘中磷脂酰肌醇3激酶(PI3K)、丝氨酸/苏氨酸蛋白激酶(AKT)、凋亡因子相关受体(FasL)表达和胎膜早破(PROM)的影响。方法 回顾性分析2017年8月-2021年8月于武汉科技大学附属汉阳医院产科确诊的113例GDM孕妇,根据是否存在生殖道感染分为感染组(n=52)和未感染组(n=61),根据是否发生PROM分为PROM患者(n=34)和无PROM患者(n=79)。检测胎盘组织白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、降钙素原(PCT)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平;实时荧光定量聚合酶链反应和蛋白质印迹检测AKT、PI3K和FasL表达。结果 感染组患者感染病原菌主要是无乳链球菌(69.23%)和衣原体(28.85%);感染组患者的IL-6、TNF-α、CRP、PCT和MDA水平均高于未感染组,SOD水平低于未感染组(P<0.05);感染组患者的FasL mRNA、AKT mRNA和PI3K mRNA水平以及FasL蛋白、AKT蛋白、PI3K蛋白均高于未感染组(P<0.05);感染组患者PROM发生率为46.15%,高于未感染组的16.39%(P<0.05),PROM患者的FasL mRNA、AKT mRNA和PI3K mRNA水平以及FasL蛋白、AKT蛋白、PI3K蛋白表达水平均高于无PROM患者(P<0.05)。结论 生殖道感染使GDM孕妇胎盘中FasL、AKT、PI3K表达上调,可能通过介导免疫炎症和氧化应激反应,诱导PROM发生。OBJECTIVE To explore the effects of reproductive tract infection on placental phosphatidylinositol 3-kinase(PI3K),protein serine-threonine kinase(AKT)and factor associated suicide ligend(FasL)expression and premature rupture of membrane(PROM)in pregnant women with gestational diabetes mellitus(GDM).METHODS A retrospective analysis was performed on the 113 pregnant women diagnosed with GDM in the obstetrics department of Hanyang Hospital Affiliated to Wuhan University of Science and Technology between Aug 2017 and Aug 2021.According to whether reproductive tract infection occurred,they were divided into the infection group(n=52)and non-infection group(n=61).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),procalcitonin(PCT),superoxide dismutase(SOD)and malondialdehyde(MDA)in placental tissues were detected.The expression of PI3K,AKT and FasL were detected by real-time fluorescent quantitative polymerase chain reaction assay and western blot.RESULTS The main pathogens in the infection group included Streptococcus agalactiae(69.23%)and Chlamydia(28.85%).The levels of IL-6,TNF-α,CRP,PCT and MDA in the infection group were higher than those in the non-infection group,while SOD level was lower than that in the non-infection group(P<0.05).The mRNA levels of FasL,AKT and PI3K,and protein expression levels of FasL,AKT and PI3K in the infection group were higher than those in the non-infection group(P<0.05).The incidence of PROM in the infection group was higher than that in the non-infection group(46.15%vs 16.39%,P<0.05).The mRNA levels of FasL,AKT and PI3K,and protein levels of FasL,AKT and PI3K of the patients with PROM were higher than those of the patients without PROM(P<0.05).CONCLUSION The reproductive tract infection can up-regulate the expression of placental FasL,AKT and PI3K in pregnant women with GDM,which may induce PROM by mediating immune inflammation and oxidative stress response.

关 键 词：妊娠期糖尿病 磷脂酰肌醇3激酶 苏氨酸蛋白激酶 实时荧光定量PCR 蛋白质印迹 胎膜早破 

分 类 号：R714.25[医药卫生—妇产科学]