原因不明反复自然流产患者主动免疫治疗前后血清白细胞介素-10、巨噬细胞集落刺激因子、白血病抑制因子浓度的变化

Study on changes of serum IL-10,M-CSF,LIF levels after active immunotherapy in women with unexplained recurrent spontaneous abortion

目的探讨原因不明反复自然流产(RSA)患者主动免疫治疗前后血清白细胞介素(IL)-10、巨噬细胞集落刺激因子(M-CSF)、白血病抑制因子(LIF)浓度的变化。方法采用酶联免疫吸附法检测20例正常非妊娠妇女(正常非孕组)、20例正常妊娠妇女(正常妊娠组)和20例RSA患者(流产组)淋巴细胞主动免疫治疗前后血清中IL-10、M-CSF、LIF的水平。结果(1)流产组治疗前血清IL-10、M-CSF的水平分别为(0.19±0.05)ng/L(、100.99±8.32)ng/L,明显低于正常非孕组的(0.24±0.03)ng/L(、110.97±11.82)ng/L(P<0.01);LIF(109.99±8.55)ng/L与正常非孕组(108.47±6.66)ng/L比较,无显著性差异(P>0.05)。(2)流产组治疗后血清IL-10(0.23±0.023)ng/L、M-CSF(110.37±7.88)ng/L,明显高于治疗前(P<0.01);LIF(111.25±8.96)ng/L与治疗前比较,无显著性差异(P>0.05);三种细胞因子的水平与正常非孕组比较,无显著性差异(P>0.05)。(3)正常妊娠组IL-10(0.27±0.028)ng/L、M-CSF(120.34±11.37)ng/L、LIF(118.38±9.58)ng/L,明显高于正常非孕组(P<0.01,P<0.05,P<0.01)。结论原因不明RSA与血清IL-10、M-CSF水平降低有关,主动免疫治疗可上调IL-10、M-CSF的水平,可考虑以IL-10、M-CSF作为RSA的检测指标。

Objective：To investigate the changes of serum interleukin （IL）-10, macrophage-colony stimulating factor （M-CSF）, leukemia inhibitory factor （LIF） levels after active immunotherapy in women with unexplained recurrent spontaneous abortion （RSA）. Methods：Concentrations of IL-10, M-CSF, and LIF were measured by enzyme-linked immunosorbant assay （ELISA） method in sera from twenty women with unexplained RSA before and after active immunotherapy. Twenty normal non-pregnancy （NNP） women and twenty normal pregnancy （NP） women were taken as control. Results：Serum concentrations of IL-10 and M-CSF were lower significantly （P〈0.01） in RSA women （0. 19±0.048 ng/L and 100.99±8. 32 ng/L, respectively） than those in NNP women （0.24±0. 026 ng/L and 110.97±11.82 ng/L, respectively）. However, there were no significant differences in serum concentrations of LIF between RSA women and NNP women. After active immunotherapy, serum concentrations of IL-10 and M-CSF were increased significantly（0. 23±0. 023 ng/L and 110.37±7. 88 ng/L, respectively,P〈0.01） whereas no significant changes in serum concentrations of LIF were found in RSA women. As compared to NNP women, RSA women showed no significant differences in serum concentrations of the above-mentioned cytokines after active immunotherapy. Serum concentrations of IL-10, M-CSF and LIF were higher significantly （P〈0. 01,P〈0.05,P〈0. 01, respectively） in NP women （0.27±0. 028 ng/L, 120. 34±11.37 ng/L and 118.38±9.58 ng/L, respectively） than those in NNP women. Conclusion. The results suggest that low serum IL-10 and M-CSF may play an important role in the maintenance of pregnancy and that they can be used as parameters for determining RSA risk.