人类白细胞抗原G的表达与子痫前期发病的关系

Relationship between the expression of human leukocyte antigen G and preeclampsia

目的通过检测子痫前期孕妇相关组织中人类白细胞抗原G（HLA—G）的表达，探讨其与子痫前期发病的关系。方法选择2009年3月至12月在陕西省妇幼保健院产科住院分娩的子痫前期孕妇30例，根据病情分为轻度子痫前期组8例，重度子痫前期组22例。选择同期健康孕妇30例为对照组。3组孕妇均以剖宫产方式分娩。采用ELISA法检测孕妇外周血、脐血及羊水中的可溶性HLA—G（sHLA—G）水平；采用蛋白印迹法检测胎盘、胎膜及脐带组织中HLA—G蛋白的表达。结果（1）各组孕妇外周血、脐血、羊水中sHLA—G水平：轻、重度子痫前期组孕妇外周血sHLA—G水平分别为（50±14）、（30±6）μg/L，新生儿脐血中sHLA—G水平分别为（34±10）、（26±8）μg/L，均明显低于对照组的（100±16）、（70±9）μg／L，分别与对照组比较，差异均有统计学意义（P〈0．01）；重度子痫前期组与轻度子痫前期组比较，差异也有统计学意义（P〈0．01）。重度子痫前期组新生儿脐血中sHLA—G水平虽低于轻度子痫前期组，但差异无统计学意义（P〉0．05）。轻、重度子痫前期组孕妇羊水中sHLA—G水平分别为（26±7）、（25±5）μg/L，均低于对照组的（27±6）μg／L，但分别与对照组比较，差异无统计学意义（P〉0．05）；轻度子痫前期组与重度子痫前期组比较，差异也无统计学意义（P〉0．05）。（2）各组孕妇胎盘、胎膜及脐带组织中的HLA-G蛋白表达：对照组胎盘组织中HLA—G蛋白表达水平为1．59±0．36，胎膜组织中表达水平为0．42±0．09，胎盘组织中的HLA—G蛋白表达水平明显高于胎膜组织，两者比较，差异有统计学意义（P〈0．05）；对照组脐带组织中HLA—G蛋白表达水平为0．24±0．17，分别与胎盘及胎膜组织中的HLA—G蛋白表达水平比较，差异均有统计学意义（P〈0．01）。轻度子痫前期组胎盘组织中HLA—G蛋白表达水平为0．78±0．21，重度子痫前期组为0．29±0．17，分别与对照组比较，差异均有统计学意义（P〈0．01）。轻、重度子痫前期组孕妇胎膜及脐带组织中均未检测出HLA—G蛋白的表达。结论与健康孕妇相比，HLA—G在子痫前期孕妇外周血、脐血及胎盘组织中呈明显低表达，HLA—G表达水平的异常可能与子痫前期的发病有关。

Objectives To detect the expression of human leukocyte antigen-G （HLA-G） in tissuesfrom pregnant women with preeclampsia and discuss the relationship between HLA-G and preeclampsia. Methods Pregnant women with preeclampsia in Maternal and Child Health Hospital of Shaanxi Province from March 2009 to December 2009 were included. Eight were included into mild preeclampsia groups and 22 were included into severe preeclampsia group. And 30 age-matched normal pregnancies were referred as the control group. All women in the three groups received cesarean section. The soluble HLA-G （sHLA-G）levels in peripheral blood, umbilical blood and amniotic fluid were examined by ELISA; the expressions of HLA-G protein in placenta, fetal membrane and umbilical cord were examined by western blot. Results （ 1 ） The sHLA-G levels in peripheral blood, umbilical blood and amniotic fluid in each group. The sHLA-G levels in peripheral blood in mild and severe preeclampsia group were （50 ± 14 ） and （30 ±6）μg/L respectively, and the sHLA-G levels in umbilical blood were （34 ±10） and （26 ±8）μg/L respectively. All were significantly lower than those in the control group （ P 〈 0. 01 ）, which were （100 ± 16） and （70 ±9） μg/L respectively. There was also statistical difference between mild and severe preeclampsia group （P 〈 0. 01 ）, Although the sHLA-G level in umbilical blood of severe preeclampsia group was lower than that in mild preeclampsia group, there was no statistical difference （ P 〉 0. 05 ）. The sHLA-G levels in amniotic fluid in mild and severe preeclampsia groups were （ 26±7 ） and （ 25 ± 5 ） Ixg/L respectively, which were lower than that in the control group （27 -＋ 6） μg/L, but the differences were not significant （P 〉 0. 05 ）. There was no statistical difference between mild and severe preeclampsia groups （ P 〉 0. 05 ）. （2） The expression levels of HLA-G protein in placenta, fetal membrane and umbilical cord in each group. The expression levels of HLA-G in placenta and fetal membrane in the control group were 1.59 ±0. 36 and 0.42 ± 0. 09 respectively. The expression of HLA-G in placenta was significantly higher than that in fetal membrane （P 〈 0. 05 ）. The expression level of HLA-G in umbilical cord in the control group was 0. 24 ± 0. 17, statistically different from those in placenta and fetal membrane, respectively （P 〈 0. 01 ）. The expression levels of HLA-G in placenta in mild and severe preeclampsia groups were 0. 78± 0. 21 and 0. 29 ± 0. 17 respectively, significantly different from the control group （P 〈 0. 01 ）. There was no expression of HLA-G in fetal membrane and umbilical cord in mild and severe preeclampsia groups. Conclusions The expressions of HLA-G in the peripheral blood, umbilical blood and placenta in women with preeclampsia are significantly lower than those in normal pregnant women. The abnormal expression of HLA-G might be associated with the pathogenesis of preeclampsia.