免疫球蛋白联合绒毛膜促性腺激素对原因不明复发性流产患者外周血Th17/Treg平衡的影响

目的探讨免疫球蛋白联合绒毛膜促性腺激素对原因不明复发性流产患者外周血Th17/Treg平衡的影响。方法选取有原因不明复发性流产病史且妊娠后行免疫球蛋白联合绒毛膜促性腺激素进行保胎治疗的孕妇20例,作为治疗组,于治疗前后分别留取孕妇外周血;选取正常妊娠妇女20例作为对照组,留取其外周血。采用RT-PCR和ELISA方法检测外周血中IL-17、IL-6、IL-10和TGF-β1的表达水平。结果 (1)治疗组治疗前外周血中Th17相关细胞因子IL-17和IL-6表达水平高于对照组(P<0.05),Treg相关细胞因子IL-10和TGF-β1表达水平低于对照组(P<0.05),差异有统计学意义。(2)治疗组治疗后与治疗前相比,IL-17和IL-6表达水平明显下降(P<0.05),IL-10和TGF-β1表达水平明显上升(P<0.05),差异有统计学意义。(3)治疗组治疗后与对照组相比,外周血中IL-17、IL-6、IL-10和TGF-β1四种细胞因子表达水平均无明显差异(P>0.05)。(4)治疗组中IL-17与IL-6,IL-10与TGF-β1存在明显的正相关性。结论复发性流产的发生与Th17/Treg平衡失调有关,调节Th17/Treg平衡失调可能是免疫球蛋白联合绒毛膜促性腺激素治疗复发性流产的机制之一。

The effect of immunoglobulin combined with hCG on Th17/Treg balance in peripheral blood of unexplained recurrent spontaneous abortion patients

Objective To investigate the effect of the administration of immunoglobulin combine hCG on Th17/Treg balance in unexplained recurrent spontaneous abortion（URSA）. Methods Selected 20 cases of pregnant women as treatment group who had a history of unexplained recurrent spontaneous abortion and underwent the combine therapy of immunoglobin plus hCG, whose peripheral blood samples were taken before and after treatment respectively;20 cases of normal pregnant women were chosen as control group. Semi-quantitative RT-PCR and ELISA were applied to detect the concentrations of IL-17, IL-6, IL-10 and TGF-β1 in the peripheral blood of both groups. Results （1）Expression levels of Th17 related cytokines IL-17 and IL-6 were significantly higher in peripheral blood of treatment group before treatment than control group（P〈0.05）; Treg related cytokines IL-10 and TGF-β1 levels were decreased compared with the control group（P〈0.05）. （2）After treatment, IL-17 and IL-6 levels of treatment group were lower than before（P〈0.05）; while IL-10 and TGF-β1 levels were increased（P〈0.05）. （3） Compared with the control group, the levels of IL-17, IL-6, IL-10 and TGF-β1 of treatment group with aftertreatment were not significantly different, P〉0.05. （4） IL-17 and IL-6, IL-10 and TGF-β1 of treatment group were positively correlated. Conclusion The happening of recurrent miscarriage may be associated with Th17/Treg balance disorder, and correcting the disorder of Th17/Treg balance may be one of the mechanisms of immunoglobin combined hCG to treat URSA.