自然流产绒毛及蜕膜细胞凋亡的基因调控研究

目的应用流式细胞仪和免疫组织化学技术检测自然流产绒毛及蜕膜细胞凋亡及bax、bcl-2基因调控．探讨自然流产发病机制和基因调控机制，为进一步自然流产基因治疗研究提供理论依据。方法对20例自然流产病例和正常早孕吸宫流产病例的绒毛与蜕膜组织进行研究。常规光镜观察细胞形态学变化；DNA倍体分析检测细胞凋亡及其周期变化；免疫组化S-P法检测bcl-2／bax基因蛋白表达率比值。结果自然流产绒毛、蜕膜组织形态学结构均出现不同程度的退形性改变，自然流产中绒毛及蜕膜细胞凋亡率均较正常妊娠明显增高（P〈0．05）。蜕膜凋亡率尤其明显。自然流产的绒毛和蜕膜中抑凋亡基因bcl-2表达也较正常早孕时下降（P〈0．001），而促凋亡基因bax表达自然流产中显著增高（P〈0．001），结果与细胞凋亡的发生一致。结论细胞凋亡在胚胎的发育过程中起着重要作用，自然流产绒毛和蜕膜组织中大量的细胞凋亡是其形态学退变的重要原因，并进而阻碍了胚胎的发育。

Control of Apoptosis of Human Chorionic Villi and Decidua Cells During Spontaneous Abortion

Objective Using flow cytometric and immunohistochemical methods to examine the mechanisms of apoptosis of human chorionic villi and decidua cells during spontaneous abortion (SA). Methods Chorionic villi and decidua cells from 20 subjects were collected and analyzed. Histological changes were determined using light microscopy. Expression of bcl-2 and bax gene proteins was determined using immunohistochemical methods. Results Extensive pathological change was observed in chorionic vill. The apoptosis index (AI) of cells in villi and decidua in the SA group was higher than the selected abortion group (P<0.05). Expression of bcl-2 genes in these tissues were decreased compared with their counterparts (P<0.001), while the expression of bax gene was significantly increased in the SA group (P<0.001). Conclusion The presence of a large population of apoptotic cells in chorionic villi and decidua might contribute to the morphological changes of these tissues, and also the development of the fetus.