补体异常激活在复发性流产中的作用

摘要

复发性流产(recurrent spontaneous abortion,RSA)为与同一性伴侣发生连续3次或3次以上的自然流产.补体激活的适当抑制是正常妊娠所必需的,母胎界面补体过度激活可导致胚胎死亡、RSA等妊娠并发症.流产动物模型表明补体系统由经典途径或旁路途径激活,产生的C3a、C5a趋化激活中性粒细胞或单核细胞,促使其分泌B因子、D因子,激活、放大旁路途径,形成补体激活的恶性循环.活化的中性粒细胞或单核细胞经可溶性血管内皮生长因子受体1(sFlt-1)途径和组织因子(TF)途径导致RSA等妊娠并发症.但目前对于补体异常激活的关键途径、重要补体组分及致RSA的机制尚不清楚,有待于进一步的研究.%Recurrent spontaneous abortion is that a patient suffered from spontaneous abortion for three times or more than three times continuously with the same man.Appropriate complement inhibition is an absolute requirement for normal pregnancy.Uncontrolled complement activation in the maternal-fetal interface leads to fetal death and recurrent spontaneous abortion including other pregnancy complications.It is said that complement system is abnormally activated by classical pathway or alternative pathway in murine models in RSA,and C3a or C5a may lead to RSA by sFlt-1 pathway and tissue factor way.However,there is still dispute on key pathways for complement activation,indispensable complement constituent,and the effector mechanisms leading to fetal loss,which need more researches to explore.