细胞免疫功能的变化与原因不明习惯性流产的关系

目的探讨细胞免疫功能的变化与原因不明习惯性流产（unexplained habitual abortion，UHA）的发生及主动免疫治疗机制的关系。方法2002-08—2004-08汕头大学医学院第一附属医院采用流式细胞仪测定并比较112例UHA患者和30例正常已生育妇女及76例经主动免疫治疗后的UHA患者外周血CD3^＋、CD4^＋、CD8^＋、CD18^＋CD56^＋细胞亚群比例及CD4^＋／CD8^＋的比值；同时比较76例采用主动免疫治疗和36例未采用主动免疫治疗的UHA者再次妊娠成功率。结果UHA患者与正常已生育妇女比较，血中CD3^＋、CD16^＋CD56^＋细胞的百分率及CD4^＋／CD8^＋比值增高，差异有显著性意义（P〈0．05）。主动免疫后CD3^＋、CDl6^＋CD56^＋细胞百分率及CD4^＋／CD8^＋比值下降（P〈0．05）。经主动免疫治疗的UHA者再次妊娠成功率为88．24％，对照组为31．25％，两组比较差异有非常显著性意义（P〈0．01）。结论淋巴细胞亚群比例的改变与UHA的发生有关，主动免疫治疗可调节异常的细胞免疫功能，有利于提高再次妊娠成功率。     

自发性早产母胎界面子宫自然杀伤细胞亚群及T淋巴细胞亚群变化的研究

目的:研究不明原因早产发生时,母胎界面中自然杀伤细胞亚群及T淋巴细胞亚群的变化,探讨早产发生机制.方法:采用流式细胞技术,分别检测足月妊娠分娩孕妇30例(正常妊娠组)和不明原因孕周满28周至不满37周无医学指针终止妊娠的孕妇30例(早产组)母胎界面底蜕膜组织中CD4+T细胞、CD8+T细胞、CD56+CD16+NK细胞百分比、Th1及Th2细胞的百分比.结果:①早产组患者CD4+T细胞、CD56+CD16+NK细胞百分比明显高于正常妊娠组(P<0.05),CD8+T细胞百分比明显低于正常妊娠组(P<0.05);②早产组Th1细胞、Th1/Th2比例明显高于正常妊娠组(P<0.01).结论:母胎界面局部T淋巴细胞亚群、子宫自然杀伤细胞百分比的改变及Th11细胞增多与不明原因自发性早产相关.     

原因不明复发性流产患者外周血及蜕膜组织中CD+4CD+25调节性T细胞比例的变化

目的 探讨原因不明复发性流产(URSA)患者外周血及蜕膜组织中CD+4CD+25调节性T(Tr)细胞比例的变化.方法 采用双荧光标记流式细胞分析技术检测25例URSA患者(流产组)、34例正常早孕妇女(正常妊娠组)和22例正常非孕妇女(正常非孕组)外周血及蜕膜组织中CD+4CD+25Tr细胞的比例.结果 (1)流产组和正常妊娠组妇女外周血CD+4 CDbright25T细胞的比例[分别为(1.55±0.77)%、(2.65±1.10)%]均显著高于正常非孕组妇女[(0.39±0.14)%],分别比较,差异均有统计学意义(P<0.05);流产组妇女外周血CD+4 CDbright25T细胞的比例显著低于正常妊娠组妇女,两组比较,差异有统计学意义(P<0.05).(2)流产组妇女蜕膜组织中CD+4 CDbright25T细胞比例[(0.59±0.23)%]显著低于正常妊娠组妇女[(1.24±0.55)%],两组比较,差异有统计学意义(P<0.01).流产组妇女蜕膜组织中CD+4CDdim25T细胞比例[(4.23±1.52)%]与正常妊娠组[(3.75±1.88)%]比较,差异无统计学意义(P>0.05).(3)正常妊娠组妇女蜕膜组织中CD+4CDbright25T细胞占CD+4T细胞的比例(CD+4CDbright25/CD+4)为(13.10±10.25)%,显著高于外周血[(5.59±2.62)%],两者比较,差异有统计学意义(P<0.05);流产组患者蜕膜组织中CD+4CDbright25/CD+4比例[(5.16±2.83)%]与外周血[(4.64±2.07)%]比较,差异无统计学意义(P>0.05).结论 CD+4CD+25Tr细胞数量在早孕期显著升高,参与了正常妊娠的维持,有可能是调控母-胎界面局部免疫耐受形成的一个重要因素;CD+4 CD+25Tr细胞数量的减少可能与URSA的发生有关.     

早孕蜕膜及绒毛组织中趋化因子CXC受体3、4及其配体的表达变化和意义

目的 探讨早孕蜕膜及绒毛组织中趋化因子CXC受体(CXCR)3、4及其配体CXCL9、CXCL10和CXCL12的表达变化和意义.方法 体外分离正常早孕蜕膜组织中单个核细胞,免疫磁珠分选试剂盒纯化CD+56自然杀伤(NK)细胞,流式细胞仪分析其纯度和表型;RT-PCR技术榆测早孕蜕膜NK细胞中CXCR3和CXCR4、早孕蜕膜及绒毛组织中CXCL9、CXCL10、CXCL12的表达情况;免疫组化链霉菌抗生物素蛋白-过氧化物酶连接(SP)法检测正常子宫内膜、早孕蜕膜组织中CXCL9和CXCL10的表达及CD+56NK细胞的分布情况,分析CXCL9、CXCL10表达量(灰度值)与CD+56NK细胞数的相关性.结果 分离纯化的早孕蜕膜NK细胞中,98.7%的细胞表型为CD56bright;早孕蜕膜NK细胞中有CXCR3和CXCR4表达;早孕蜕膜组织中有CXCL9、CXCL10表达,早孕绒毛组织中有CXCL12的表达.分泌期子宫内膜中CXC19、CXCL10表达最为56±43、59±47,较增生期子宫内膜的16±18、8±14明显升高,差异有统计学意义(P<0.05),而早孕蜕膜组织中CXCL9、CXCL10表达量为143±35、158±29,较分泌期子宫内膜进一步升高(P<0.05);分泌期子宫内膜中NK细胞数量为(60±20)个,增生期子宫内膜中NK细胞数量为(23±4)个,两者比较,差异有统计学意义(P<0.05),早孕蜕膜中NK细胞数量为(114 ±15)个,较分泌期子宫内膜进一步增多(P<0.05);子宫内膜和蜕膜组织中CXCL9、CXCL10表达量与组织中CD56+细胞数呈正相关关系(rcxL9=0.88,P<0.05;rcxcL10=0.86,P<0.05).结论 早孕蜕膜及绒毛组织中表达的CXCL9、CXCL10及CXCL12可能通过与CD56+NK细胞表面对应的趋化因子受体CXCR3、CXCR4结合而影响早孕期母-胎界面中CD56+NK细胞的聚集,从而对母-胎间免疫平衡起调控作用.     

足月妊娠母胎界面与系统免疫中NK细胞表型和T细胞变化的研究

目的探讨足月妊娠母胎界面及系统免疫中NK、T细胞的免疫状态变化及其相互关系。方法对10例正常足月妊娠妇女,剖宫产同时采集子宫底蜕膜、外周静脉血,通过流式细胞技术,检测其NK细胞亚群、NK细胞表面受体CD69、CD94及Th1/Th2免疫状态。结果底蜕膜和外周血中各指标结果为:CD56brightCD16-含量:(18·72±17·73)%和(0·28±0·18)%;CD56+CD69+亚群:(34·98±19·79)%和(3·33±1·27)%;CD56brightCD94+含量:(15·94±13·19)%和(1·17±1·19)%;CD56+CD16-/CD56+CD16+比值:(2·30±2·25)和(0·34±0·28);CD56+CD69+/CD56+CD94+比值:(1·21±0·66)和(0·28±0·12),差异均有统计学意义(P<0·01);底蜕膜中Th1、Th2、Tc1细胞含量及Th1/Th2、Tc1/Tc2比值与外周血均无显著性差异(P>0·05);子宫底蜕膜中自然杀伤细胞(uterine natural killer cell,uNK细胞)亚群,uNK细胞表面受体CD69、CD94,Th1/Th2免疫状态与外周血均无相关性(P>0·05)。结论与维持妊娠免疫耐受关系极大的uNK细胞,在足月妊娠底蜕膜中保持相对的活化状态,同时uNK、T细胞的变化独立于外周血中的免疫状态。     

自然流产者蜕膜组织CD56+NK细胞Fas的表达意义

目的:研究自然流产妇女蜕膜组织的CD56+NK细胞Fas(CD95)表达与生物学功能,评估CD56+NK细胞不同亚群表型对自然流产患者免疫功能的影响。方法:收集48例自然流产者蜕膜组织,应用流式细胞术分析CD56+CD95+NK细胞的表达情况。结果:48例自然流产者CD56+CD95+NK细胞表达36例,统计结果表明,自然流产组与对照组相比差异性有显著意义。结论:通过检测NK细胞Fas表达可在一定程度上反映NK细胞的毒性,用于诊治复发性自然流产患者具有一定的临床价值。     

妊娠中晚期外周血T淋巴细胞亚群和NK细胞的观察

目的 :检测孕妇外周血T淋巴细胞亚群和NK细胞的变化 ,探讨正常妊娠时母体的细胞免疫状态。方法 :健康孕妇 92例按孕周分为 3组 :中孕组 (孕周 13～ 2 7+ 6周 )、晚孕未足月组 (孕周 2 8～ 36 + 6周 )和足月组 (孕周 37～ 4 1+ 6周 ) ;另取同期健康未孕生育年龄妇女 2 0例作对照组。用流式细胞仪检测其外周血T淋巴细胞亚群和NK细胞的相对数 ,结合外周血白细胞计数计算其绝对数。结果 :正常孕妇外周血白细胞总数显著增加 ,其中粒细胞百分数和绝对数均显著增加 ,单核细胞绝对数增加 ,淋巴细胞百分数和绝对数均显著减少 ;CD3+ 细胞百分数显著增加 ,CD4 + 细胞百分数和绝对数均显著减少 ,CD4 + /CD8+ 比值显著下降 ,CD8+ 细胞差异无显著性 ;NK细胞百分数和绝对数均显著减少。随着孕周进展 ,CD4 + 细胞百分数和绝对数均逐渐减少 ,CD4 + /CD8+ 比值逐渐下降 ,中孕组与晚孕未足月组比较 ,差异有显著性 (P <0 .0 5 )。结论 :妊娠期母体细胞免疫功能处于免疫抑制状态 ;随着妊娠进展 ,这种抑制有一定程度的下降。     

子宫蜕膜NK细胞和妊娠

子宫蜕膜中NK细胞是妊娠早期出现最多的淋巴细胞,与外周NK细胞(CD16+CD56-)相比,子宫NK细胞表面抗原通常为CD56+CD16-mCD3-.在着床过程中,NK细胞的活性一般处于抑制状态.从子宫NK细胞的细胞毒性作用和分泌的细胞因子阐述其在妊娠期可能起的作用,提示子宫NK细胞与反复自然流产、异位妊娠及先兆子痫的关系.说明在复杂的母胎界面免疫内分泌网络中,子宫NK细胞能影响滋养细胞侵入过程和胎盘的生长发育.     

子宫自然杀伤细胞在胚胎着床期功能的研究进展

子宫自然杀伤(u NK)细胞是存在于女性子宫中的一类特殊的免疫细胞,表型主要为CD~(56bright) CD16~-,在正常妊娠早期表现为强大的免疫调节功能及相对较弱的细胞毒性,其在胚胎着床过程中有着重要的作用,包括细胞因子及生长因子的分泌,促进滋养层细胞入侵蜕膜以及蜕膜和胎盘的血管生成等。u NK细胞功能及数量的异常被认为与多种妊娠相关疾病有关,如复发性流产、子痫前期等。本综述目的在于汇总对子宫自然杀伤细胞的最新研究,将有助于了解这些疾病的发病机制,最终指导临床的预防与治疗。     

原因不明复发性流产蜕膜CD4~+CD25~+CD127~(dim/-)Treg细胞对自然杀伤细胞的功能调控

目的探讨原因不明复发性流产(URSA)患者蜕膜CD4+CD25+CD127dim/-Treg细胞对自然杀伤(NK)细胞的功能调控。方法留取2007年2月至2009年2月上海交通大学医学院仁济医院5例URSA患者(URSA组)和5例正常早孕人流妇女(对照组)蜕膜组织,制备成单个核细胞悬液,用免疫磁珠分离法分离出CD4+CD25+CD127dim/-Treg细胞和NK细胞,将CD4+CD25+CD127dim/-Treg细胞和NK细胞共培养,用LDH释放实验测定共培养后NK细胞毒性变化,FCM法测定共培养后NK细胞胞内IFN-γ、穿孔素(perforin)产生情况。结果共培养后对照组和URSA组NK细胞的毒性均比单独纯化NK细胞的毒性明显降低(P=0.002,P=0.03),URSA组NK细胞毒性较对照组高(P0.001);对照组和URSA组NK细胞内细胞因子INF-γ、perforin的水平分别较单独纯化NK细胞内细胞因子水平明显降低[INF-γ(P=0.001,P=0.02);perforin(P=0.01,P=0.03)],URSA组NK细胞INF-γ、perforin的表达较对照组高(P0.001,P0.001)。结论 CD4+CD25+CD127dim/-Treg细胞对NK细胞功能有抑制作用;URSA中Treg细胞免疫抑制功能的下降,是NK细胞的活化异常和毒性增加的原因之一。     

Study on the activity and phenotype of decidual natural killer cells in patients with unexplained habitual abortions

Habitualabortionsoccurin 1to 2 %ofthechild bearingpopulation .Chromosomalaberrationistheprincipalcauseoffetallossduringtheearlystageofgestation .Oth eretiologies ,whichincludeanatomicanomalies ,endocrinedisorders,andinfections ,havealsobeendocumemtedinpatientswithhabitualabortions .Nevertheless ,in 4 0to6 0 %ofcouples ,habitualabortionsremainunexplained ,whicharecalledUHA .Recently ,theimportanceofim munologyinUHAisrecognized .Immunecellsareabun dantinhumandeciduaandarecapableofrespondingto…     

NK Cells Detect Changes in Adaptive Immunity within Mouse Decidua from Gestation Day Eight

Viable human CD56+ CD16? peripheral blood Natural Killer (NK) cells show specific in vitro binding under shear forces to ligands expressed by endothelial cells in cryostat sections of gestation day (gd)7 mouse decidua basalis. In serial assays, numbers of cells adhering to gd7 tissue are constant for men but have cyclical variation for fertile women, suggesting a brief gain in functional decidual homing potential of this NK cell subset during the menstrual cycle. Regardless of gender, numbers of adhering cells from an individual donor, increase dramatically when the substrate is decidua basalis from a later gestational timepoint. Here, we report that human blood CD56+ CD16? NK cells which adhere as single cells over gd7 decidua basalis, adhere as large clusters over gd8 and gd9 tissues, suggestive of antigen recognition and lymphocyte activation. We asked which cells within mouse decidua basalis trigger this response in CD56+ CD16? cells. Using decidua from mice transgenic for myeloid dendritic cell (mDC) expression of enhanced yellow fluorescent protein (eYFP), we found cluster formation was independent of mDC contact. Use of decidua from alymphoid mice showed clustering behavior required substrate lymphocytes. By use of decidua containing NK cells but lacking T and B cells, decidual T and/or B lymphocytes were identified as the cells altered after gd7 in a manner that activates CD56+ CD16? cell clustering. This timepoint is just prior to mouse spiral arterial modification and its detection by these indicator cells implicates adaptive, decidual immune responses in the regulation of NK cell function.     

Lymphocyte subset distribution and cytokine secretion in third trimester decidua in normal pregnancy and preeclampsia

BACKGROUND: Excessive Th1 activity in peripheral blood plays a probable role in the pathogenesis of preeclampsia. The aim of the study was to investigate whether disturbed local immune reactions are also present in decidua. METHODS: Flow cytometric analysis of CD3, CD19, CD56/CD16, CD4, CD8, CD4/CD29, CD4/CD45RA, CD4/CD45RO, CD8/CD28, CD3/CD69 lymphocyte subsets isolated from third trimester decidua of pregnants with preeclampsia (n=21) and pregnant controls (n=11) subjected to elective caesarean sections. Spontaneous and phytohemaglutynine stimulated "in vitro" secretion of IL-2, IL-4, IL-6, IL-10, IL-12, IFN-gamma and TGF-beta by decidual lymphocytes was studied by ELISA. For the statistical significance of differences between the groups the U Mann-Whitney test was performed (confidence interval P<0.05). RESULTS: Preeclamptic patients were characterized with an increased percentage of the CD3-/CD56+CD16+, CD8+/CD28+ and decreased percentage of CD3+, CD19+, CD4+/CD45RA+ lymphocytes. The profile of secreted cytokines shifts in favor of Th1 activity (extremely high IFN-gamma and low IL-6 and IL-10 secretion). Decidual IL-12 secretion in preeclamptic patients is decreased compared to controls. CONCLUSION: Changes in NK and T lymphocyte subsets followed with Th1 cytokine IFN-gamma over-activity, could affect local immunoregulatory mechanisms in third trimester decidua of preeclamptic patients.     

Phenotypic and functional characterization of rhesus monkey decidual lymphocytes: rhesus decidual large granular lymphocytes express CD56 and have cytolytic activity

In this study, we carried out a phenotypic and functional characterization of lymphocytes isolated from the uterine endometrium of the pregnant rhesus monkey. A majority (80%) of these cells were CD56(bright+), CD3- had typical large granular lymphocyte/uterine natural killer (NK) cell morphology and contained numerous cytoplasmic granules. Flow cytometric evaluation showed that rhesus decidual CD56(bright+) cells shared other phenotypic features of human uterine NK cells, including low levels of CD45RA and CD62L expression. A majority of the rhesus uterine CD56(bright+) cells expressed low levels of CD 16 but were CD2-. In contrast, most rhesus CD16+ peripheral blood cells were CD56-. In addition to the primary population of CD56(bright+) cells, a minor subset of smaller and less granular CD56(intermediate+) decidual lymphocytes was identified, the majority of which were CD16-, CD2(+). Decidual CD56+ cells did not express monocyte/macrophage markers, including CD14, CD64 and CD68. Decidual lymphocytes effectively lysed K562, Raji and particularly 721.221 targets in cytotoxicity assays. Together, these results suggest that as in human pregnancy, rhesus decidual CD56(bright+) cells represent a distinct lymphocyte subset that belongs to the NK cell lineage.     

子痫前期患者母-胎界面子宫自然杀伤细胞免疫表型及辅助性T淋巴细胞1、2免疫状态的研究

目的探讨母．胎界面子宫自然杀伤细胞免疫表型及辅助性T淋巴细胞（Th）1、2免疫状态的变化与子痫前期发病的关系。方法于剖宫产时采集20例子痫前期患者（子痫前期组）及11例正常妊娠妇女（正常对照组）的子宫底蜕膜组织,应用流式细胞技术检测两组产妇底蜕膜组织中子宫自然杀伤细胞亚群,子宫自然杀伤细胞表面受体CD69、CD94及Th1／Th2免疫状态。结果（1）子痫前期组底蜕膜组织中子宫自然杀伤细胞CD56^bright CD16^-亚群及CD56^dim CD16^＋亚群的含量分别为（17．3±11．1）％及（16．3±8．7）％,正常对照组分别为（17．9±16．8）％及（16．2±8．8）％,两组分别比较,差异无统计学意义（P〉0．05）。（2）子痫前期组底蜕膜组织中子宫自然杀伤细胞CD56^＋CD69^＋及CD56^＋CD94^＋的含量分别为（37．9±18．9）％及（34．9±15．2）％,正常对照组分别为（36．8±19．7）％及（32．7±16．2）％,两组分别比较,差异无统计学意义（P〉0．05）。（3）子痫前期组CD56^＋CD69^＋／CD56^＋CD94^＋值为1．1±0．2,正常对照组为1．2±0．6,两组比较,差异无统计学意义（P〉0．05）。（4）子痫前期组底蜕膜组织中细胞毒性T淋巴细胞（Tc）2型细胞含量为（3．0±1．0）％,正常对照组为（4．3±0．9）％,两组比较,差异有统计学意义（P〈0．001）;子痫前期组Tc1／Tc2值为17．8±3．4,正常对照组为11．8±4．6,两组比较,差异有统计学意义（P〈0．001）;子痫前期组Th1／Th2值15．1±2．4,正常对照组为13．2±3．1,两组比较,差异无统计学意义（P〉0．05）。结论子痫前期患者底蜕膜组织中母-胎界面的子宫自然杀伤细胞免疫表型无明显变化;但Tc1／Tc2值向Tcl偏移,使得母-胎界面Th1／Th2免疫状态向Th1型免疫偏移,这一现象可能与子痫前期发病有关。     

Comparison of decidual leukocytes following spontaneous vaginal delivery and elective cesarean section in uncomplicated human term pregnancy

The aim of this study was to quantify and compare leukocyte populations in term decidua basalis and parietalis obtained after spontaneous vaginal delivery (SVD) or elective cesarean section (CS) without labor. Decidua basalis and parietalis samples were obtained from placentas after SVD (n = 20) and after CS (n = 30). Following mechanical disaggregation, leukocytes were purified and stained with monoclonal antibodies. Percentages of leukocyte subclasses within the CD45(+) cell fraction and activated T cells were determined by flow cytometry. No differences were found in the percentages of CD45(+) cells or CD56(bright)CD16(-) uterine natural killer (NK) cells between decidua basalis from SVD and CS or between decidua parietalis from SVD and CS. In decidua basalis and parietalis from SVD, a significantly higher number of CD56(dim)CD16(+) NK cells was found compared to CS. In decidua basalis from SVD, there was a significantly lower percentage of CD14(+) cells and higher percentage of CD19(+) cells compared to CS. The percentage of CD3(+) T cells expressing CD25 or human leukocyte antigen (HLA)-DR was significantly decreased in decidua basalis and parietalis from SVD compared to CS. Comparison of decidua collected after SVD or CS suggests that labor is associated with dynamic changes in the distribution of decidual leukocytes, specifically NK and T cell subpopulations. In particular, the disappearance of the CD4(+)CD25(+) T cell population, which possibly contains a subpopulation of regulatory T cells, may contribute to the initiation of labor. Further investigation into factors affecting decidual leukocytes may expand our understanding of the immunological events at the maternal-fetal interface.     

Decidual lymphocyte subsets in pregnant women

OBJECTIVES: Materno-foetal immunological reactions in decidua are probably one of the most important elements in pathogenesis of preeclampsia. DESIGN: To compare lymphocyte subsets isolated from decidua of preeclamptic pregnant women with lymphocyte subsets isolated from healthy pregnant women. MATERIALS AND METHODS: Preeclampsia (PE) was defined according to USA National Health Institute criteria. The study group consisted of 21 women with PE and 11 women with physiological pregnancy. All pregnancies were finished with elective cesarean sections. Exclusion criteria were: uterine contractions, infection, chorinamnionitis, diabetes mellitus and therapy with steroids less than 7 days before blood sampling. Decidual tissue was obtained by curettage of the uterine cavity. The fragments of decidua were separated from clotted blood and placed in sterile tubes with 5 ml of isotonic solution (PBS). Then the decidual tissue was mechanically fragmented, homogenized and rinsed in PBS. Routine immunofluorescent marking techniques with monoclonal antibodies were performed. Analysis was done with FACSCalibur flow-cytometer with 488 nm argon laser using CellQuest programme. The following lymphocyte subsets were estimated: CD3, CD19, CD4, CD8, CD4/CD29, CD8/CD28, CD4/CD45RA, CD4/CD45RO, CD56/CD16, CD69. The results were described as percentage of lymphocytes positive for above surface molecules. Statistical analysis was performed using t-Student and U-Mann-Whitney tests. The work was sponsored by KBN 4 P05E 118 15 grant. RESULTS: Decidua of pregnant PE women contains significantly increased percentage of CD3-/ CD56 + 16+, CD8+/CD28+ cells and decreased percentage of CD3+, CD19+, CD4+/CD29+ and CD4+/CD45RA+ compared to decidua of healthy pregnant controls. CONCLUSIONS: These changes suggest that deficiency of suppressor activity as well as aberrant immunoregulation exists in decidual tissue of PE women.     

Decidual leucocyte populations in early to late gestation normal human pregnancy

Most research on human decidual leucocytes to date has focused on the predominant CD56+ uterine natural killer (uNK) cell population in early pregnancy. Few reports have documented decidual leucocyte populations after 13 weeks gestation and in late pregnancy. Placental bed (decidua basalis) and non-placental bed (decidua parietalis) biopsies from normal pregnancies were taken from women undergoing termination of pregnancy in the 1st and 2nd trimesters and following Caesarean section in the 3rd trimester. Immunohistochemistry was used to quantify the numbers of decidual cells expressing CD56, CD3, CD8, CD94, NKG2A and CD14 and double labelled CD161+CD3+ NKT-like cells. Although a significant reduction in CD56+ uNK cells was found in 3rd trimester samples compared with 1st and 2nd trimester decidua, a substantial residual CD56+ leucocyte population was identified in 3rd trimester decidua. Expression of the KIR CD94/NKG2A mirrored that of CD56 at all gestational ages, providing an explanation for the absence of cytotoxic responses at the fetal–maternal interface. There was no difference in leucocyte populations between decidua basalis and decidua parietalis. Double immunohistochemical labelling revealed small numbers of decidual CD3+CD56+ and CD8+CD56+ cells, which decreased in number at term, and CD161+CD3+ cells, which increased in number at term. No differences in leucocyte populations were detected between decidua parietalis and decidua basalis. In contrast to previous reports, a substantial residual CD56+ cell population was demonstrated in 3rd trimester decidua. Decidual cytotoxic T-lymphocytes did not alter in number during gestation, while in contrast CD14+ macrophages decreased at term, representing the smallest decidual population assessed.     

低剂量米非司酮对植入窗口期子宫内膜中子宫自然杀伤细胞数量及其亚型含量的影响

目的 探讨低剂量米非司酮对植入窗口期子宫内膜中子宫自然杀伤(uNK)细胞数量及其亚型含量的影响.方法 收集正常妇女植入窗口期的子宫内膜14份,将每份内膜组织平均分为3部分,分别用浓度为65 nmol/L米非司酮(A组)、200 nmol/L米非司酮(B组)和0 nmol/L米非司酮(对照组)进行体外培养,运用免疫组化和流式细胞技术检测uNK细胞数量及CD-3CD+56CD-16亚型、CD-3CD+56CD+16亚型的百分含量.结果 (1)A、B及对照组子宫内膜中CD+56uNK细胞数量分别为(148±11)、(150±12)和(121±7)个,A、B组分别与对照组比较,差异均有统计学意义(P＜0.05);A、B组之间比较,差异无统计学意义(P＞0.05).(2)A组和B组子宫内膜中CD-3CD+56亚型百分含量分别为(44±5)%和(48±4)%,高于对照组[(35±3)%],差异有统计学意义(P＜0.05),A、B组间比较,差异无统计学意义(P＞0.05);A组和B组子宫内膜CD-3 CD+56CD-16亚型百分含量分别为(42±5)%和(45±5)%,高于对照组[(33±3)%],差异有统计学意义(P＜0.05),A、B组间比较,差异无统计学意义(P＞0.05);CD-3CD+56CD+16亚型百分含量分别为(2.70±0.24)%、(3.26±0.37)%和(2.33±0.29)%,3组间比较,差异无统计学意义(P＞0.05).结论 低剂量米非司酮可通过增加uNK细胞数量及CD-3CD+56CD-16亚型百分含量,使植入窗口期子宫内膜局部免疫微环境失平衡,从而可能导致胚胎植入的失败.