Th17及相关细胞因子在妊娠早期母-胎免疫耐受中的作用

目的:研究Th17细胞及相关细胞因子IL-22、IL-23在人孕早期不明原因的自发性流产母-胎免疫耐受中的作用。方法:以10例正常人工流产患者为正常早孕组,收集18例染色体正常自发性流产患者为自然流产组。分离两组患者外周血单个核细胞及蜕膜组织免疫细胞,用流式细胞术检测上述细胞中Th17细胞比例及相关细胞因子的表达,探讨其与自发性流产的关系。结果:自然流产组外周血Th17细胞比例显著高于正常早孕组(P<0.05),IL-23显著低于正常早孕组(P<0.01),但两组IL-22无显著差异;自然流产组蜕膜局部Th17细胞比例显著高于正常早孕组(P<0.01),IL-23亦显著高于正常早孕组(P<0.01),IL-22则显著低于正常早孕组(P<0.01)。结论:Th17细胞在孕早期蜕膜局部及外周血中的数量增多可能导致母胎免疫耐受失衡,在早期自然流产中发挥重要的正诱导作用,而IL-22、IL-23等细胞因子在其中的调控效应则具有明显的微环境相关性。

The biological functions of T helper 17 cells and related cytokines in human maternal-fetal immune tolerance of early pregnancy

Objective:To explore roles of Th17 cells and the expression of Th17-related cytokines IL-22 and IL-23 in maternal-fetal immune tolerance of human early pregnancy.Methods:The peripheral blood and deciduas of 18 spontaneous abortion as the targeted group as well as 10 self-induced abortion of normal pregnancy women as a control group in early pregnancy were collected separately.Immunofluorescence flow cytometry was used to analyze and compare the difference of CD4+IL-17+T cell(Th17 cells) population as well as the expression of cytokines IL-22,and IL-23 in peripheral blood and deciduas of the two groups,respectively.Results:Comparing with the control group,the ratio of Th17 cells in peripheral blood increased significantly(P<0.05),and the expression of IL-23 was lower significantly(P<0.01)in the targeted group,although the expression of IL-22 showed no significant difference.Regarding the difference analysis in decidua specimens,the targeted group showed significantly higher Th17 cells population(P<0.01),higher IL-23 expression(P<0.01),but lower IL-22 expression(P<0.01)compared with the control group.Conclusion:The increase of Th17 cells population in the deciduas and peripheral blood of early pregnancy may result in the imbalance of maternal-fetal immune tolerance and thus contribute great role in early spontaneous abortion,although the specific effect of cytokines IL-22 and IL-23 in maternal-fetal immune tolerance correlate closely with the micro-environment.