胎盘外泌体在子宫螺旋动脉重铸不全相关妊娠并发症中的作用

子宫螺旋动脉重铸是胎盘滋养细胞与母体血管内皮、平滑肌细胞、免疫细胞等相互作用下完成的,细胞间信息传递在这一过程中起重要作用。外泌体的发现更新了学者们对细胞间信息传递的思考模式。外泌体是细胞主动分泌的直径40~100 nm的囊泡,可由多种细胞分泌并可从多种体液中分离出来,携带多种蛋白质、mRNA、微小RNA(miRNA)等信号分子,在细胞间通讯起重要作用。研究证明,胎盘滋养细胞能分泌外泌体,在母血中能检测并分离出胎盘外泌体,胎盘外泌体携带滋养细胞信息,作用于母体细胞,调节血管形成,重铸子宫螺旋动脉,调节母体免疫,参与胎盘屏障的形成。综述胎盘外泌体的特征、生物学功能及其在螺旋动脉重铸不全相关妊娠并发症中的变化,探讨胎盘外泌体作为诊断妊娠并发症血清标志物的临床价值。

The Role of Placenta Exosomes in Pregnancy Complications Associated with Dysfunctional Remodeling of Uterine Spiral Arteries

Uterine spiral artery remodeling is accomplished by the interaction between the maternal vascular endothelial cells, smooth muscle cells, immune cells and placenta trophoblast cells. Cell-to-cell communication plays an important role in the process. Our understanding of how cells communicate has undergone a paradigm shift since the finding of the role of exosomes in intercellular signaling. Exosomes are automatically secreted homogenous membrane vesicles with a diameter of 40-100 nm which have been found to be released by various cell types and isolated from biological fluids. Exosomes carry a variety of mRNA, microRNA and proteins which play an important role in cell-to-cell communication. Studies have shown that exosomes can be released by placenta trophblast. Placenta exosomes can be identified and isolated in maternal blood which carry informations of trophblast acting on the target cells. The biological functions of placenta exosomes include regulating immune tolerance, remodeling of uterine spiral arteries, promoting angiogenesis and formating the placental barrier，ect. This article summarized the characteristics and functions of placenta exosomes and the changes in pregnancy complications associated with dysfunctional remodeling of uterine spiral arteries, to explore the clinical value of placenta exosomes as a serum marker in diagnosis of pregnancy complications.