原因不明复发性流产患者与正常早孕妇女蜕膜活化和抑制分子的比较

The expression of activated and inhibitory molecule in deciduas of unexplained recurrent spontaneous abortion and normal pregnancy

目的探讨原因不明复发性流产(URSA)患者和正常妊娠妇女蜕膜活化和抑制分子的变化。方法2003年3月至2005年2月采用实时定量逆转录-聚合酶链反应(RT-PCR)检测上海仁济医院25例URSA患者与32例正常妊娠妇女蜕膜组织CTLA-4、GITR、CD69、CD40L、OX40 mRNA的表达。结果URSA患者蜕膜组织CD69、CD40L、OX40 mRNA的表达较正常妊娠患者显著升高,CTLA-4、GITR mRNA的表达显著降低。结论UR-SA患者蜕膜局部的免疫环境失调,活化分子表达增强、抑制因子表达下调,可能影响了CD4+CD25+调节性T细胞的分化,导致母胎耐受形成障碍,介导了URSA的发生。

Objective To study the expression of activated and inhibitory molecule in deciduas of unexplained recurrent spontaneous abortion（URSA） patients and normal pregnancy（ NP）women. Methods The expression of CTLA-4,GITR, CD69.CD40L.OX40 mRNA in deciduas from 25 cases of URSA and 32 cases of NP were detected by Real-time PCR. Results The expression of OX40,CD40L.CD69 mRNA in deciduas of URSA patients were significantly higher compared to NP women ,while the levels of CTLA-4,GITR mRNA was significantly lower in URSA patients than that in NP women. Conclusion The above findings suggest that the disturbance of immunoloregnlatory environment in deciduas increases the activated marker and decreases inhibitory marker,which may affect the differentiation of CD4^＋ CD25^＋ Tr and maintaining of maternal-fetal tolerance, resulting in spontaneous abortion.