复发性流产患者主动免疫治疗后淋巴细胞免疫表型的变化

目的探讨原因不明复发性流产(URSA)患者行淋巴细胞主动免疫治疗(LIT)后淋巴细胞免疫表型的变化对治疗效果的评估价值。方法采用流式细胞术分析URSA患者LIT前后外周血T淋巴细胞、B淋巴细胞、NK细胞和调节性T细胞免疫表型的变化(P0.05)。结果 25例URSA患者经LIT后成功妊娠16例,治疗后所有URSA患者(n=25)和妊娠成功组(n=16)外周血CD3+T细胞、CD4+HLA-DR+T细胞比例较治疗前均明显增加,CD4+T和CD3-CD56+NK细胞比例明显降低(P0.05);而治疗前后B细胞和Treg细胞、CD56bright CD16-NK、CD56dimCD16+NK、CD3+CD56+NKT及CD69+NK细胞比例则无明显变化(P0.05)。结论 LIT后外周血T细胞、NK细胞的比例发生了明显变化,CD4+T细胞、CD3-CD56+NK细胞比例降低和CD3+T细胞、活化CD4+T细胞增加也许有利于维持妊娠,T细胞和NK细胞的免疫表型有望作为LIT疗效评估的一个重要指标。

Changes of lymphocyte immune phenotype after lymphocyte immunotherapy in the patients with recurrent spontaneous abortion

Objective： To investigate the changes of lymphocyte immune phenotype after lymphocyte immunotherapy（LIT）for unexplained recurrent spontaneous abortion（URSA）patients.Methods：The phenotypes of T cells,B cells,Treg cells and NK cell in peripheral blood of URSA patients were determined by flow cytometry before and after lymphocyte immunotherapy.Results：Sixteen patients with URSA had already delivered or been pregnant more than 20weeks（successful pregnancy group）in a total of 25 patients.There was no obvious difference in the proportion of peripheral B cells,Treg cells and CD56 bright CD16^-NK,CD56dimCD16^＋NK,CD3^＋CD56^＋NK,CD69^＋NK（activated）cells in URSA patients（n=25）or successful pregnancy group（n=16）before and after LIT.The proportion of CD^3＋T cell and CD4^＋HLA^-DR^＋T cell was significantly increased,while the proportion of CD4^＋T cell and CD3-CD56＋NK cells was decreased after LIT（P0.05）.Conclusions：The proportion of T cells and NK cells in peripheral blood is changed obviously after LIT.The CD4^＋T cells,CD3^-CD56^＋NK cells are decreased and the CD3^＋T cells are increased.The activated CD4＋T cells might be beneficial for pregnancy maintenance.The immune phenotypes of T cells and NK cells could be used as one of the important indicators for the therapeutic effect of LIT.