免疫治疗不明原因反复自然流产患者群体反应抗体、TGF-β和nTreg表达变化的研究

摘要

目的：：探讨不明原因反复自然流产( URSA)患者经免疫治疗后其血清群体反应抗体( PRA)、转化生长因子β(TGF-β)和外周血单个核细胞(PBMC)中转录调节因子3(FOXP3)阳性的天然调节性T细胞(nTreg,CD4+CD25+FOXP3+)表达的变化及临床意义。方法：应用酶联免疫及流式分析方法,分别检测正常妊娠组及URSA患者免疫治疗后未孕组和妊娠组血清PRA、TGF-β含量及外周血单个核细胞nTreg表达率。结果：RSA患者经免疫治疗后未孕组血清PRA、TGF-β中位数较免疫治疗后妊娠组中位数降低(27．5%、107．7 pg/L vs 68．75%、189．9 pg/L,P<0．01)；未孕组nTreg表达率中位数也较妊娠组低(5．05% vs 8．05%,P<0．01)。结论：URSA患者经免疫治疗后其血清PRA的产生及TGF-β含量增加和nTreg的诱导性升高是RSA患者经免疫治疗后成功妊娠的重要因素,PRA、TGF-β及nTreg的检测对RSA患者的免疫治疗方案的确定和疗效判断有重要的临床意义。%Objective: To investigate the effects of immunotherapy on PRA, TGF-β and CD4+CD25+Foxp3+ nTreg cells in women with unexplained recurrent spontaneous abortion. Methods:We detect the level of PRA,TGF-βin serum and the expression of nTreg cells in peripheral blood of pregnant, non pregnant and natural fertility women by enzyme immunoassay and flow cytometry. Results:After immunotherapy,the median level of PRA and TGF-βin non pregnant group was lower than that in pregnant group(27. 5%,107. 7 pg/L vs 68. 75%,189. 9 pg/L,P<0. 01). Compared to pregnant group,the median expression rate of nTreg cells were lower in non pregnant group(5. 05% vs 8. 05%,P<0. 01). Conclusion:The PRA,TGF-βand nTreg cells are critical factors for pregnancy in RSA patients. It is helpful to identify and judge the effect of immunotherapy by detect the level of panel reactive antibodies,TGF-β in serum and the expression rate of nTreg cells in peripheral blood.