妊娠期高血压疾病患者外周血中Th22/Th17/Th1细胞变化及临床意义

目的:分析妊娠期高血压疾病(HDP)患者外周血中Th22、Th17和Th1细胞及相关细胞因子水平的变化,探讨促炎性CD4+T细胞在疾病演变过程中的作用。方法:选择妊娠期高血压疾病患者90例,其中妊娠期高血压及轻、重度子痫前期(PE)患者各30例作为实验组,另选择同期正常妊娠孕产妇30例作为对照组。采用流式细胞技术检测Th22、Th17和Th1细胞的比例,通过ELISA法测定外周血中IFN-γ、TNF-α、IL-6、IL-17和IL-22的浓度。结果:妊娠期高血压组中患者外周血Th1细胞及IFN-γ水平明显高于正常妊娠组(P<0. 05),且二者水平呈正相关(P<0. 05);轻度子痫前期组中Th17细胞及IL-6、IL-17和IL-22水平与妊娠期高血压组比较差异具有统计学意义(P<0. 05),且Th17细胞比例与IL-6、IL-17含量均呈正相关(P<0. 05);重度子痫前期组Th22/Th17/Th1细胞及相关细胞因子水平均明显高于其他各妊娠组(P<0. 05),且TNF-α、IL-6和IL-22含量均与Th22细胞比例呈正相关(P<0. 05);重度早发型PE组TNF-α和IL-22水平均高于晚发型PE组(P<0. 05)。结论:促炎性CD4+T细胞及相关细胞因子协调作用,共同加重炎症反应,可能是妊娠期高血压疾病发生、发展的重要因素。孕妇外周血中Th22/Th17/Th1细胞水平的异常变化与HDP的病情密切相关,有望成为联合诊断的重要指标。

Alteration and clinical significance of circulating Th22/Th17/Th1 cells in patients with hypertensive disorders of pregnancy

Objective:To analyze the changes of Th22,Th17 and Th1 cells and the related cytokines in peripheral blood of patients with hypertensive disorders of pregnancy(HDP),and explore the role of inflammatory CD4+T cells in the progress of HDP.Methods:Ninety patients with HDP including gestational hypertension(30 cases),mild preeclampsia(30 cases)and severe preeclampsia(30 cases)were selected as study groups,thirty healthy pregnant women matched for gestational weeks were selected as control group.The frequencies of Th22,Th17 and Th1 cells were determined by flow cytometry,the concentrations of IFN-γ,TNF-α,IL-6,IL-17 and IL-22 was detected by enzyme-linked immunosorbent assay(ELISA)in peripheral blood.Results:The levels of Th1 cells and IFN-γin peripheral blood of patients in gestational hypertension group were significantly higher than the normal pregnancy group(P<0.05),there was a positive correlation between circulating Th1 cells and IFN-γin gestational hypertension group(P<0.05).The levels of Th17 cells and IL-6,IL-17 and IL-22 in mild preeclampsia were significantly different from those in gestational hypertension group(P<0.05),and the percentage of Th17 cells was positively correlated with the plasma levels of IL-6 and IL-17(P<0.05).The levels of Th22,Th17 and Th1 cells and the related cytokines in severe preeclampsia were significantly higher than other groups(P<0.05),and the plasma concentration of TNF-α,IL-6 and IL-22 showed positive correlation with the frequency of Th22 cells in severe PE group,respectively(P<0.05).In severe early-onset PE group,the levels of TNF-αand IL-22 were higher than that in late-onset PE group(P<0.05).Conclusion:The coordinated action of proinflammatory CD4+T cells and related cytokines can aggravate inflammatory reaction,which may be an important factor in the occurrence and development of hypertensive disorders of pregnancy.The abnormal changes of Th22/Th17/Th1 cells in the peripheral blood of pregnant women are closely related to the condition of HDP,and it is expected to be an important indicator of the combined diagnosis.