胎盘辅助性T细胞因子IL-4、IL-6和IFN-γ与子痫前期关系的研究

目的:通过研究辅助性T细胞因子IL-4、IL-6及IFN-γ在子痫前期患者及血压正常的晚期妊娠妇女(NLP)胎盘母体面与胎儿面中的表达规律,探讨其在子痫前期发病过程中的病理生理机制。方法:选取子痫前期和正常妊娠孕妇作为研究组和对照组,应用免疫组化方法对两组胎盘的母体面与胎儿面Th1型细胞因子(IFN-γ)和Th2型细胞因子(IL-4、IL-6)进行标记并通过彩色病理图像分析系统对染色结果进行定量检测并作比较。结果:①胎盘母体面滋养细胞IFN-γ表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.2034±0.0148、0.2688±0.0278、0.2075±0.0154,子痫前期重度组与正常妊娠组差异有统计学意义(P0.001);IL-6表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.1864±0.0009、0.1579±0.0070、0.1862±0.0127,子痫前期重度组与正常妊娠组差异有统计学意义(P0.001);IL-4表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.2026±0.0163、0.1994±0.0163、0.2011±0.0124,3组比较差异均无统计学意义(P0.05)。②胎盘胎儿面滋养细胞IFN-γ、IL-6、IL-4在子痫前期轻度组、重度组及正常妊娠组表达的平均光密度均无统计学差异。③子痫前期重度组滋养细胞IFN-γ、IL-6表达的平均光密度在胎盘母体面与胎儿面比较差异有统计学意义(P0.05);IL-4表达的平均光密度在胎盘母体面与胎儿面比较,无统计学差异(P0.05)。结论:在重度子痫前期孕妇胎盘母体面中表现为免疫杀伤的Th1型细胞因子表达增强,表现为免疫保护的Th2型细胞因子则表达减弱,而在胎盘胎儿面则无上述表现,提示胎盘母体面的Th1/Th2细胞因子失衡可能是导致子痫前期发病的病因之一。

Study on relationship between IL-4,IL-6 and IFN-γ in helper T cells of placenta and preeclampsia

Objective:To explore the physiopathologic mechanism of helper T cell (Th cell) cytokines 〔IL-4,IL-6 and interferon-γ (IFN-γ)〕 in occurrence of preeclampsia by investigating the expression patterns of IL-4,IL-6 and IFN-γ on maternal surface and fetal surface of placentas of patients with preeclampsia and normotensive women of late pregnancy.Methods:The patients with preeclampsia and normotensive women of late pregnancy were selected as study group and control group,respectively,then Th1 cytokine (IFN-γ) and Th2 cytokines (IL-4,IL-6) on maternal surface and fetal surface of placentas were marked,and the results of staining were detected quantificationally by color pathological image analysis system and compared.Results:The average optical density of IFN-γ expression on maternal surface of placenta in mild preeclampsia group,severe preeclampsia group and normal pregnancy group were (0.203 4±0.014 8),(0.268 8±0.027 8) and (0.207 5±0.015 4),respectively,there was significant difference between severe preeclampsia group and normal pregnancy group (P<0.001); the average optical density of IL-6 expression on maternal surface of placenta in mild preeclampsia group,severe preeclampsia group and normal pregnancy group were (0.186 4±0.000 9),(0.157 9±0.007 0) and (0.186 2±0.012 7),respectively,there was significant difference between severe preeclampsia group and normal pregnancy group (P<0.001); the average optical density of IL-4 expression on maternal surface of placenta in mild preeclampsia group,severe preeclampsia group and normal pregnancy group were (0.202 6±0.016 3),(0.199 4±0.016 3) and (0.201 1±0.012 4),respectively,there was no significant difference among the three groups (P>0.05).On fetal surface of placenta,there was no significant difference in average optical densities of IL-4,IL-6 and IFN-γ among the three groups.In severe preeclampsia group,there was significant difference in average optical densities of IFN-γ and IL-6 between maternal surface and fetal surface of placenta (P<0. 05); there was no significant difference in average optical density of IL-4 between maternal surface and fetal surface of placenta (P>0.05).Conclusion:On maternal surface of placenta in patients with severe preeclampsia,the expression of Thl cytokine who plays an immunologic injury role increases,the expressions of Th2 cytokines who plays an immunologic protection role decrease,but the condition is not found on fetal surface of placenta,which indicate that imbalance of Thl and Th2 cytokines on maternal surface of placenta may be one of the pathogenesis of preeclampsia.