Toll样受体与自然流产

Toll-like Receptors and Spontaneous Abortion

正常妊娠时母体免疫系统对同种移植物的胎儿产生免疫耐受。宫内感染等因素可使母体免疫系统排斥胎儿,引起流产。Toll样受体(Toll-like receptors,TLRs)是组成天然免疫的模式识别受体的主要家族,参与母胎界面的抗微生物的天然免疫反应,在正常妊娠的维持和自然流产的发生中发挥重要作用。TLRs可与入侵的病原体相互作用激活母体的天然免疫抵抗感染,同时可能介导母胎界面的微环境改变,使炎症细胞因子表达失调,自然杀伤(NK)细胞等天然免疫细胞异常激活,诱导滋养细胞过度凋亡,从而导致流产的发生。TLRs还参与抗磷脂抗体诱发的母胎界面血栓形成的过程,诱发流产。

Successful pregnancy is attributed to the maternal-fetal immune tolerance. Spontaneous abortion may be induced by intrauterine infection which can initiate the maternal immune system to reject the fetal. Toll-like receptors（TLRs）form the major family of pattern recognition receptors in the innate immune system and play an important role in maintaining normal pregnancy and promoting the development of spontaneous abortion because TLRs are involved in the innate immune responses against microorganisms at the maternal-fetal interface. The interaction between TLRs and invading pathogen can active the innate immune system to resist infection,at the same time,spontaneous abortion may be induced because the immune response may make microenvironment at the maternal-fetal interface change. At the maternal-fetal interface,inflammatory cytokines can be released imbalancedly,innate immune cells may be activated inappropriately,which may lead to trophoblast cells excessive apoptosis and eventually result in abortion. TLRs is also associated with antiphospholipid mediating thrombosis at the maternal-fetal interface and fetal loss.