药物流产出血模型小鼠雌、孕激素水平与Th17/Treg亚群的关系#br#

摘要：目的　研究药物流产出血模型小鼠的雌、孕激素水平与Th17/Treg亚群的关系。方法　选取清洁级Balb/c雌性小鼠32只，通过随机数字表法分为正常妊娠组（A组）、小剂量米非司酮组（B组）、大剂量米非司酮组（C组）、米非司酮+宫清颗粒组（D组），每组8只。B、C、D组小鼠于妊娠第6天时分别使用米非司酮0.88 mg·kg-1·d-1、1.5 mg·kg-1·d-1及米非司酮（1.5 mg·kg-1·d-1）+宫清颗粒组（308.16 mg·kg-1·d-1）灌胃。采用改良碱性正铁血红素法检测子宫出血量；采用放射免疫法检测血清雌二醇（E2）、孕酮（P）水平；采用流式细胞术双染色法检测子宫组织Th17（CD3+CD4+IL-17A+）、Treg（CD4+CD25+Foxp3+）及Th17/Treg亚群比值；采用逆转录聚合酶链式反应（RT-PCR）法检测子宫组织白细胞介素（IL）-17A、IL-10、转化生长因子（TGF）-β mRNA水平。结果　B、C、D组子宫出血量依次减少。药物流产后，A、B、C、D组小鼠E2水平依次升高，而P水平依次降低。Th17亚群依次升高，Treg亚群依次降低，Th17/Treg亚群比值依次升高（均P＜0.05）。IL-17A mRNA相对表达量依次升高，而IL-10、TGF-β mRNA相对表达量依次降低（均P＜0.05）。血清E2与Th17、Th17/Treg和IL-17A水平呈正相关，与Treg、IL-10和TGF-β水平呈负相关；血清P与Treg、IL-10和TGF-β水平呈正相关，与Th17、Th17/Treg和IL-17A水平呈负相关（均P＜0.05）。结论　药物流产后的异常子宫出血血清E2、P水平变化与Th17/Treg亚群比值变化关系密切，诱导Th17/Treg亚群向Th17偏移有助于减少子宫出血。

The relationship between estrogen and progesterone levels and Th17/Treg subgroups in the hemorrhagic model mice after medical abortion

Abstract: Objective　To study the relationship between estrogen (E2) and progesterone (P) levels and Th17/Treg subgroups in the hemorrhagic model mice after medical abortion. Methods　Thirty-two female Balb/c mice with clean grade were selected and divided into normal pregnancy group (group A), low-dose mifepristone group (group B), high-dose mifepristone group (group C) and mifepristone + gongqing granules group (group D) by random number table method, with 8 mice in each group. Mice in group B, C and D were gavaged with mifepristone 0.88 mg·kg-1·d-1, 1.5 mg·kg-1·d-1 and mifepristone (1.5 mg·kg-1·d-1) + gongqinggranules (308.16 mg·kg-1·d-1) during d 6 pregnancy, respectively. Alkaline hematin photometric method was used to detect uterine blood loss. The serum E2 and P levels were detected by rdioimmunoassay (RIA). The uterus tissue Th17 (CD3+CD4+IL-17A+), Treg (CD4+CD25+Foxp3+) and the ratio of Th17/Treg subsets were detected by flow cytometry double staining method, and the uterus tissue interleukin 17A (IL-17A), interleukin 10 (IL-10) and transforming growth factor (TGF-β) mRNA levels were detected by RT-PCR method. Results　The uterine bleeding volume decreased in turn in group B, group C and group D (P＜0.05). After drug abortion, the E2 levels increased in turn in group A, group B, group C and group D, while the P levels decreased in turn in group A, group B, group C and group D (P＜0.05). The ratio of Th17 and Th17/Treg subgroups of mice decreased in turn in the four groups, while the Treg subgroup ratio decreased in turn (P＜0.05). The levels of IL-17A mRNA increased in turn in the four groups (P＜0.05), andthe levels of IL-10 mRNA and TGF- β mRNA were decreased in turn in the four groups (P＜0.05). The serum level of E2 was positively correlated with Th17, Th17/Treg and IL-17A mRNA, and negatively correlated with Treg, IL-10 and TGF-β (all P＜0.05). The serum level of P was positively correlated with Treg, IL-10 and TGF-β, and negatively correlated with Th17, Th17/Treg and IL-17A (all P＜0.05). Conclusion　The changes of serum E2 and P levels in abnormal uterine bleeding after medical abortion are closely related to the changes of Th17/Treg subgroup ratio, and inducing Th17/Treg subgroup to migrate to Th17 can help reduce uterine bleeding.