Th1/Th2型细胞因子在药物流产绒毛和蜕膜组织中的表达

Expression of Th1/Th2 cytokines in trophoblasts and deciduas of early medical abortion

目的了解米非司酮药物流产局部绒毛、蜕膜组织中Th1/Th2型细胞因子的表达,进一步探讨药物流产发病机制。方法Th1/Th2型细胞因子以白介素-2(Interleukin-2,IL-2)、干扰素-γ(Interferon gamma,INF-γ)/白介素-4(Interleukin-4,IL-4)、白介素-10(Interleukin-10:IL-10)为代表,采用原位杂交及免疫组化方法对40例药物流产患者绒毛和蜕膜中IL-2、INF-γ、IL-4、IL-10的表达进行检测(实验组),利用计算机CMIAS系统,表达指标以阳性数密度(N/S)计算,并与40例正常人工流产的绒毛和蜕膜组织比较(对照组)。结果原位杂交显示实验组绒毛组织IL-2、INF-γ、IL-4、IL-10分别为[(0.003±0.001)、(0.0027±0.0007)、(0.0±0.0)、(0.031±0.008)],与对照组[(0.0027±0.001)、(0.0028±0.0007)、(0.0±0.0)、(0.042±0.011)]比较,IL-10差异有统计学意义(P<0.05)。蜕膜组织实验组IL-2、INF-γ/IL-4、IL-10[(0.0±0.0)、(0.0±0.0)/(0.029±0.010)、(0.028±0.010)]与对照组[(0.0±0.0)、(0.0±0.0)/(0.031±0.005)、(0.032±0.006)]比较,差异无统计学意义(P>0.05)。免疫组化结果显示与原位杂交一致。结论绒毛组织Th1/Th2型细胞因子与流产有关,蜕膜组织Th1/Th2型细胞因子与药物流产无关,绒毛组织Th1/Th2平衡失调是米非司酮导致流产的机制之一。

Objective To investigate the expression of Th1/Th2 cytokines in trophoblasts and deciduas in early medical abortion. To explore the mechanism of medical abortion induced by mifepristone. Methods Th1/Th2 cytokines were represented by IL- 2, INF- γ/IL- 4 and IL- 10. The expression of these eytokines in trophoblasts and deciduas were detected by in situ hybridization and immunohistocbemistry assay in 40 medical abortion cases （test group） and 40 vacuum aspiration cases （control group）. The positive expression of cytokines was represented by number density （N/S） using computer CMIAS. Results The expression of IL- 10 in the test group was different from the control group in trophoblasts [ （0. 031±0. 008） vs. （0. 042±0. 011）], but no difference was found in expression of IL - 2 [ （0. 003±0. 001） vs. （0. 002 7±0. 001） ] or INF- γ/IL- 4 [ （0. 002 5±0. 000 7） vs. （0. 002 8± 0. 000 7）]. The same results were obtained by immunohistochemistry assay. In deciduas, no significant difference was found between the two groups by either in situ hybridization or immunohistochemitry assay. Conclusion The imbalance expression of Th1/Th2 cytokines in trophoblasts but not in deciduas may be one of the mechanisms of mifepritone induced medical abortion.