母胎界面Fas及其配体FasL表达与妊娠期高血压疾病的关系

目的:探讨母胎界面上Fas及其配体FasL表达与妊娠期高血压疾病的关系。方法:采用免疫组化方法对49例产妇母胎界面上Fas及其配体FasL表达进行测定,其中正常孕足月产妇16人,妊娠期高血压疾病轻度子痫前期产妇18名,妊娠期高血压疾病重度子痫前期15名,所有患者均为剖宫产分娩。结果:妊娠期高血压疾病组胎盘滋养细胞Fas表达较正常孕足月组增强并随病情加重更为明显,而FasL着色较正常孕足月组减弱,随病情加重更为明显。在底蜕膜细胞中,随妊娠期高血压疾病的加重FasL表达与正常孕足月相比逐渐减弱。结论:母胎界面Fas及其配体FasL表达紊乱,致使局部免疫反应增强,免役豁免机制被破坏,而高表达的Fas引起胎盘滋养细胞及底蜕膜细胞随之增加,导致胎盘侵蚀异常,血管重铸障碍,可能是妊娠期高血压疾病发病的重要机制之一。

Investigation on the relationship between the expression of Fas/FasL in maternal-fetal interface and hypertensive disorder complicating pregnancy.

Objective:To investigate the relationship between the expression of Fas/FasL in maternal-fetal interface and hypertensive disorder complicating pregnancy.Methods:The expression of Fas/FasL in maternal-fetal interface was examined in 49 cases of pregnant women by immunohistochemical staining.All of the cases delivered through caesarean section,including 16 cases of normal third trimester pregnancy,18 cases of mild eclampsism and 15 cases of severe eclampsism.Results:In placenta trophoblastic cells,the expression of Fas in hypertensive disorder complicating pregnancy was higher than that in normal third trimester pregnancy and became more noticeable with the aggravation of the disease,but FasL coloration in hypertensive disorder complicating pregnancy was weaker than that in normal third trimester pregnancy and weakened with the aggravation of the disease.In floor decidual cells,the expression of FasL in hypertensive disorder complicating pregnancy was lower than that in normal third trimester pregnancy and weakened with the aggravation of hypertensive disorder complicating pregnancy.Conclusion:The disordered expression of Fas and FasL in maternal-fetal interface may enhance local immunoreaction and destroy immunity privilege mechanism.High expression of Fas increases the quantities of placenta trophoblastic cells and floor decidual cells,leading to disordered blood vessel casting-form,which may be one of the most important mechanisms of hypertensive disorder complicating pregnancy.