原因不明复发性流产患者外周血PD-1、Th1/Th2型细胞因子水平测定及其相关性研究

目的探讨外周血程序性细胞死亡分子1(PD-1)及血清中Th1/Th2型细胞因子变化在原因不明复发性流产(URSA)发病中的作用。方法采用流式细胞术测定140例URSA患者接受淋巴细胞免疫治疗前后外周血PD-1水平;采用ELISA法测定患者治疗前后血清Th1(IL-2、IFN-γ)/Th2(IL-4、IL-10)型细胞因子水平,同时以102例正常已生育妇女作为对照组。结果 (1)淋巴细胞免疫治疗前与对照组相比,PD-1和Th2型细胞因子(IL-4和IL-10)显著下降(P均<0.05)。(2)淋巴细胞免疫治疗后与治疗前相比,Th1型细胞因子(IL-2和IFN-γ)含量明显下调(P均<0.05)。(3)淋巴细胞免疫治疗后与对照组相比,PD-1、Th1/Th2型细胞因子水平无显著性差别(P均>0.05)。(4)URSA患者外周血PD-1含量和血清中Th2型细胞因子水平呈正相关(r=0.67,r=0.81,P均<0.05);与Th1型细胞因子呈负相关(r=-0.55,r=-0.73,P均<0.05)。(5)淋巴细胞免疫治疗后,妊娠成功的妇女PD-1表达水平显著高于妊娠失败者(P<0.05)。结论 PD-1可能通过下调Th1/Th2型细胞因子的水平抑制URSA的发生发展。

The test and correlation analysis of PD-1, Th1/Th2 cytokine in unexplained recurrent spontaneous ;abortion patients

Objective To study the effect of programmed cell death-1 （PD-1） in peripheral blood and T helper-1 type（Th1）/T helper-2 type（Th2） cytokine in serum in patients with unexplained recurrent spontaneous abortion（URSA）. Methods Flow cytometry was used to measure the PD-1 of 140 unexplained recurrent spontaneous abortion women before and after lymphocyte immunotherapy;enzyme linked immunosorbant assay（ELISA） was used to measure Th1/Th2 type cytokines of the patients before and after lymphocyte immunotherapy, and control as 102 normal fertile women. Results （1） PD-1 and Th2 type cytokine levels were significantly decreased before the lymphocyte immunotherapy（P〈0.05）. （2） Th1 type cytokine were significantly down-regulated after the lymphocyte immunotherapy（P〈0.05）. （3） Compared with control group, PD-1, Th1/Th2 cytokine levels were not significantly different after the lymphocyte immunotherapy（P＆gt;0.05）. （4） The levels of PD-1 in peripheral blood and Th2-type cytokines in serum with URSA patients were positively correlated （r=0.67, r=0.81, P〈0.05）;and Th1-type cytokines were negatively correlated （r=-0.55, r=-0.73, P〈0.05）. （5）The percentage of PD-1 was significantly higher in successful pregnant women than those in pregnant loss after lymphocyte therapy. Conclusion PD-1 may suppress the development of URSA by down-regulating the level of Th1/Th2 cytokines.