原因不明复发性流产母胎界面白细胞介素2和白细胞介素4表达的相关研究

Expression of interleukin-2 and interleukin-4 at maternal-fetal interface in women with unexplained recurrent spontaneous abortion

目的探讨T辅助性细胞(helper T cells, Th细胞)分泌的Th1型细胞因子白细胞介素(IL)2、Th2型细胞因子IL-4在母胎免疫调节中的作用. 方法采用免疫组织化学法和酶联免疫吸附法,检测24例正常早孕及30例原因不明复发性流产的早孕绒毛、蜕膜组织、外周血IL-2、IL-4的表达及含量. 结果 IL-2、IL-4主要分布于早孕绒毛合体滋养细胞、细胞滋养细胞和蜕膜腺上皮细胞胞浆内.原因不明复发性流产早孕绒毛、蜕膜中IL-2蛋白质含量高于正常早孕妇女(P<0.01,P<0.05),IL-4蛋白质含量低于正常早孕(P<0.01,P<0.01).血清IL-2含量极低,绝大部分早孕未测出(52/54).而血清IL-4含量复发性流产显著低于正常早孕,分别为2.79(0～37.46)μg/L和4.19(2.08～30.07)μg/L(P<0.01). 结论原因不明复发性流产的发生与早孕母胎界面Th1/Th2平衡向Th1偏离有关.

Objective： To investigate the roles of Thl （interleukin-2） and Th2 （interleukin-4） cytokine balance at the fetal-maternal interface in women with unexplained recurrent spontaneous abortion. Methods： Thirty patients with unexplained recurrent spontaneous abortion （URSA） and twenty-four normal pregnancy women were included in this study. The expression of IL-2, IL-4 on chorionic villi and decidua at early pregnant was detected by immunohistochemistry, and the serum concentrations of IL-2, IL-4 were measured by enzyme-linked immunosorbant assay（ELISA）. Results： Both antigens of IL-2 and IL-4 were located in the syncytiotrophoblast,cytotrophoblast cells and decidual glandular epithelium at early pregnant. IL-2 protein was mostly seen in aborted chorionic villi and decidua from URSA patients while it presented at a much lower level in those two tissues from normal pregnancy women（P〈0.01 ,P〈0.05, respectively）. On the contrast, IL-4 expressed with higher amount in chorionic villi and deciduas from normal pregnancy women compared to URSA patients（P〈0.01,P〈 0.01, respectively）. IL-2 was not detectable in all blood samples except two of URSA patients. The blood level of IL-4 was also very low, but it was a little higher in sera from URSA patients compared to normal women（P〈0.01）. Conclusion： A shift from Th2 to Thl response at the fetal-maternal interface may contribute to unex- plained recurrent spontaneous abortion.