免疫学因素在原因不明复发性自然流产发病机制中的研究进展

Research advances in role of immune susceptibility in unexplained recurrent spontaneous abortion

原因不明复发性自然流产(unexplained recurrent spontaneous abortion,URSA)的发病率为1%~5%,属于复发性自然流产的一种早期流产(孕12周内)。母胎界面免疫耐受失衡是URSA发生的重要机制,而免疫学因素异常是造成URSA发生的主要原因。本文从与母胎免疫耐受失衡有关的固有免疫系统和获得性免疫系统中的关键因素如自然杀伤细胞、巨噬细胞、树突状细胞、封闭因子、Th1/Th2、Th17/Treg及其细胞因子以及补体等方面对URSA发病机制的研究进展进行综述,为URSA发病机制的研究以及临床特异性诊疗提供参考。

The incidence of unexplained recurrent spontaneous abortion(URSA)is 1%-5%,which is a kind of early abortion of recurrent spontaneous abortion(within 12 weeks of pregnancy).Previous studies have shown that maternal and fetal interface immune tolerance imbalance is an important mechanism of URSA occurrence,and immunological factors abnormality is the main cause of URSA occurrence.Therefore,this article comprehensively reviews the research advances in the pathogenesis of URSA from the key factors in the innate and acquired immune systems related to maternal and fetal immune tolerance imbalance,such as natural killer cells,macrophages,dendritic cells,blocking factors,Th1/Th2,Th17/Treg and their cytokines as well as complement,so as to provide scientific evidences for the study on the pathogenesis of URSA and its clinical diagnosis and treatment.