原因不明复发性流产主动免疫治疗前后CD4+ CD25+调节性T细胞表达频率的研究

目的探讨CD4^＋CD25^＋调节性T细胞（Tr）在原因不明复发性流产（URSA）患者主动免疫治疗中的作用。方法上海交通大学医学院附属仁济医院对2004-03—2005-05就诊于门诊的18例URSA患者，采用双荧光标记流式细胞分析技术，检测其淋巴细胞主动免疫治疗前后外周血CD4^＋CD25^＋Tr细胞表达频率的变化。结果主动免疫治疗后URSA组外周血中CD4^＋CD25^＋种Tr较治疗前明显增加（P〈0．05），CD4^＋CD25^＋较治疗前降低（P〈0．05）。主动免疫治疗后，妊娠成功的妇女CD4^＋CD25^brightTr显著多于妊娠失败者。结论主动免疫治疗可提高外周血CD4^＋CD25^brightTr数量，CD4^＋CD25^brightTr可能是调控母胎界面局部免疫耐受形成的一个重要因素，有可能成为URSA患者主动免疫治疗的监测指标之一。

Study on the changes of CD4 + CD25 + T regulatory cells after lymphocyte therapy in unexplained recurrent spontaueous abortion

Objective To investigate the function of CD4~ + CD25~ + T regulatory cells(Tr) in allogeneic lymphocyte therapy of unexplained recurrent spontaneous abortion(URSA) patients. Methods Eighteen URSA patients were enrolled in our study from March, 2004 to May,2005 in the outpatients department of Renji Hospital of Shanghai Jiao Tong University. The percentage of CD4~ + CD25~ + Tr in peripheral blood were measured by double-label flow cytometric analysis before and after lymphocyte therapy. Results After lymphocyte therapy, the percentage of CD4~ + CD25~ bright Tr increased significantly (P<0.05), whereas CD4~ + CD25~ dim Tr decreased significantly(P<0.05) in URSA patients compared with those before treatment. The percentage of CD4~ + CD25~ bright Tr was significantly higher in successful pregnant women than those in pregnant loss after lymphocyte therapy. Conclusions Allogeneic lymphocyte therapy can enhance the percentage of CD4~ + CD25~ bright Tr in peripheral blood. CD4~ + CD25~ bright Tr may play an important role in maintaining materno-fetal tolerance and can be served as a monitor marker for allogeneic lymphocyte therapy.