蜕膜自然杀伤细胞与不明原因反复自然流产的关系

The relationship between decidual natural killer cells and unexplained recurrent spontaneous abortion

目的通过测定子宫蜕膜自然杀伤(NK)细胞亚群及其杀伤活性,探讨其在不明原因反复自然流产(URSA)发病中的作用。方法随机选取确定URSA的患者10例为实验组,选取15例正常妊娠(NP组)为对照,采用流式细胞仪检测两组蜕膜组织NK细胞亚群,MTT还原法测定NK细胞杀伤活性。结果URSA组蜕膜中CD56+NK细胞含量显著高于NP组(P<0.01),且URSA组CD56+CD16+细胞亚群含量及CD56+CD16+/CD56+CD16-比值也较NP组显著升高(P均<0.01),而CD56+CD16-细胞亚群含量两组比较无差异(P>0.05)。蜕膜NK细胞活性URSA组为(31.60±2.62)%,而NP组仅为(15.65±2.02)%,两组蜕膜NK细胞活性有显著差异(P<0.01)。结论URSA的发生可能与NK细胞亚群失衡及杀伤活性异常增高而导致母胎间的免疫耐受平衡被打破有关。

Objective: To determine the immunophenotype (subset) and activity of decidual natural killer (NK) cells for investigating the statue of NK cellular immunity of the patients with unexplained recurrent spontaneous abortion (URSA).Methods: A total of 10 patients with URSA were studied, with 15 normal pregnant (NP) women as the control. The percentages of CD56^+ NK cells and their CD56^+CD16^+, CD56^+CD16^- subsets were (detected) by two-color flow cytometric analysis. The activity of NK cells was measured by MTT deoxidation assay.Results: The percentage of CD56^+ NK cells in decidual lymphocytes of URSA patients was as high as (92.05±11.09)%, but that of control group was (76.90±6.70)%, and there was significant difference (P<0.01) between the two groups. The percentage of CD56^+CD16^+ NK subset in URSA and NP women was (37.30±8.05)% and (22.29±3.13)% respectively, which had a significant difference (P<0.01). The percentage of CD56^+CD16^-NK subset in URSA and NP was (54.76±5.12)% and (54.60±4.48)% respectively, and no significant difference was found (P>0.05). But the ratio of CD56^+CD16^+/CD56^+CD16^- NK subsets in two groups was significantly different (P<0.01).The activity of decidual NK cells was significantly different in two groups (P<0.01). Conclusion: Abnormally raised activity and higher CD56^+CD16^+ subset, particularly the unbalanced CD56^+CD16^+ /CD56^+CD16^- subsets of decidual NK cells, are associated with URSA and may play a role in reproductive failure.