习惯性流产患者绒毛和蜕膜中Treg／Th17免疫失衡的检测及其临床意义

摘要

目的：探讨绒毛和蜕膜中调节性 T 细胞（Treg）／Th17免疫失衡在习惯性流产（RSA）患者免疫发病机制中的作用。方法收集RS A患者和自愿终止妊娠的早孕妇女（正常对照组）的绒毛和蜕膜，采用流式细胞术检测其中Treg和Th17细胞数量，采用RT‐PCR检测其中叉头翼状螺旋转录因子（Foxp3）和维甲酸相关核孤儿受体γt（RORγt）的mRNA水平；收集RSA患者和正常对照组的外周血，采用酶联免疫吸附试验（ELISA）检测其中转化生长因子‐β（TGF‐β）、白细胞介素（IL）‐10、IL‐17A和IL‐17F的水平；统计分析 Treg细胞和其相关细胞因子、Th17细胞和其相关细胞因子之间的相关性。结果和正常对照组比较，RS A患者绒毛和蜕膜中T h17细胞明显增多（均P＜0．01），Treg细胞明显减少（均 P＜0．01），RORγt的mRNA水平明显升高（均 P＜0．01），Foxp3的mRNA水平明显降低（均 P＜0．01）；RSA患者外周血中IL‐17A和IL‐17F水平明显升高（均 P＜0．01），TGF‐β和IL‐10水平明显降低（均 P＜0．01）；RSA患者和正常对照组Treg细胞数量和TGF‐β及IL‐10水平、Th17细胞数量和IL‐17A及IL‐17F水平均呈正相关（均 P＜0．01）。结论绒毛和蜕膜中 Treg／Th17免疫失衡可能与 RSA的免疫发病机制有关。%Objective To investigate the role of immune unbalance of Treg/Th17 in villus and decidua on the immunopathogenesis in recurrent spontaneous abortion (RSA) .Methods The villus and decidua specimens were col‐lected from the patients with RSA and early pregnancy women of voluntarily terminating pregnancy (normal control group) .The Treg/Th17 cell count was detected by the flow cytometry .The RT‐PCR method was adopted to detect the mRNA levels of RORγt and Foxp3 in villus and decidua .The levels of peripheral blood IL‐17A ,IL‐17F ,TGF‐βand IL‐10 in the two groups were detected by ELISA .Finally ,the correlations between Treg cells with the related cy‐tokines and between Th17 cells with the related cytokines were statistically analyzed .Results Compared with the normal control group ,the Th17 cells in villus and decidua in the patients with RSA were significantly increased (P<0 .01) ,while the Treg cells were significantly decreased(P<0 .01) ,the mRNA level of RORγt was significantly in‐creased(P<0 .01) and the mRNA level of Foxp3 was significantly decreased(P<0 .01);the peripheral blood IL‐17A and IL‐17F levels in the RSA patients were significantly increased (P<0 .01) and the TGF‐βand IL‐10 levels were significantly decreased(P<0 .01) .The Treg cells quantity was positively correlated with the peripheral blood TGF‐βand IL‐10 levels and the Th17 cells quantity was positively correlated with peripheral blood IL‐17A and IL‐17F levels in the RSA patients and the normal control group(P<0 .01) .Conclusion The imbalance of Treg/Th17 in villus and decidua may be related with the immunopathogenesis of RSA .