环孢素A对不明原因复发性流产患者外周血IFN-γ、TNF-α的调控

摘要

Objective:To explore the effect of cyclosporin A (CsA) on the expression of IFN-γ and TNF-α in peripheral blood of patients with unexplained recurrent miscarriage (uRM).Methods:The percentage of IFN-y+ and TNF-α+ CD3+ CD4+T cells from peripheral blood of 79 healthy women were analyzed by flow cytometry for developing a normal reference range.Thirty six patients with uRM characterized by increased expression of IFN-γ and/or TNF-α were recruited.The patients were given the treatment of CsA,50 mg twice a day,from the first day of menstruation to luteal phase.The expression of IFN-γ and TNF-α of the patients were determined by flow cytometry and compared before and after the treatment.Results:The expression levels of IFN γ+ CD3+ CD4+T cells and TNF-α+ CD3+ CD4+T cells in peripheral blood of healthy women were normal distribution.The 10th and 90th percentiles were 6.7％ ～30.5％ and 12.6％ ～41.0％ respectively as the normal reference range.The expression of both IFN-γ [(36.7±9.3)％00 vs.(28.5±11.0)％] and TNF-α [(52.8±7.2)％ vs.(40.9±13.8)％] in uRM patients were significantly decreased after the treatment (P＜0.01).Conclusions:The treatment of CsA can reduce the expression of IFN-γ and TNF-α,but its specific mechanism still needs further investigation.%目的 探讨环孢素A(CsA)对不明原因复发性流产(uRM)患者外周血干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-a)表达的影响. 方法 收集79例正常育龄期妇女的外周血标本,采用流式细胞仪检测其外周血CD3+ CD4+T细胞中IFNγ、TNF-α的表达水平,制定正常参考范围.入选36例IFN-γ、TNF-α表达量异常升高的uRM患者,于月经第1天口服CsA50 mg,2次/d,直至黄体中期;收集uRM患者治疗前后的外周血,采用流式细胞仪检测IFN-γ、TNF-α的表达水平并进行比较. 结果 正常育龄期妇女外周血CD3+ CD4+T细胞中IFN-γ、TNF-α的表达水平呈正态分布,以百分位数P10～P90(分别为6.7％～30.5％,12.6％～41.0％)作为正常参考范围.IFNγ和/或TNF-α异常升高的uRM患者服用CsA后,其表达量均显著降低[IFNγ:(36.7±9.3)％vs.(28.5±11.0)％,TNF-α:(52.8±7.2)％ vs.(40.9±13.8)％,P＜0.01]. 结论 CsA可以下调uRM患者外周血中IFN-γ、TNF-α的表达量,但其具体机制尚需进一步研究.