原因不明复发性流产患者外周血T淋巴细胞和NK细胞表型研究

The phenotypes of T lymphocytes and NK cells in peripheral blood of patients with unexplained recurrent miscarriage patients

目的:探讨原因不明复发性流产(URM)患者外周血T细胞、NK细胞和调节性T细胞(regulatory T cells,Treg)表型。方法:采用流式细胞术检测URM患者、正常早孕(NEP)和正常非孕妇女(NNP)外周血T细胞(CD3+、CD4+、CD8+T细胞、CD3+HLA-DR+、CD4+HLA-DR+、CD8+HLA-DR+、CD4+/CD8+比值水平)、NK细胞(CD3-CD56+、CD56dimCD16+、CD56brightCD16-、CD56+CD69+)和Treg细胞(CD4+CD25+CD127dim)表型。结果:URM组CD3+HLA-DR+、CD8+HLA-DR+T淋巴细胞均较NEP组明显增加(P<0.05),而CD4+T细胞较NNP组升高(P<0.05)。NEP组CD8+T细胞较NNP组显著增加(P<0.05),三组间CD3+T细胞及CD4+/CD8+比值无明显差异。URM组外周血CD3-CD56+、CD56dimCD16+NK细胞比例明显高于NEP组,而CD56brightCD16-NK细胞比例较NEP组和NNP组均降低(P<0.05)。URM组和NNP组CD4+CD25+CD127dimTreg比例较NEP组均减少(P<0.05)。结论:URM患者外周T淋巴细胞活化、CD56dimCD16+NK细胞增多和Treg细胞减少可能是其致病的免疫基础。

Objective To investigate the phenotypes of T lymphocytes, NK cells and regulatory T （Treg） cells in peripheral blood of patients with unexplained recurrent miscarriage patients （URM）. Methods The phenotypes ofT cells （CD3＋, CD4＋, CD8＋T cells and CD4＋/CD8＋ ratio, CD3＋HLA-DR＋, CD4＋HLA-DR＋, CD8＋ HLA-DR＋） ,Treg cells （CD4＋CD25＋CD127dim）, and NK cells （CD3- CD56＋, CD56dimD16＋, CD56＋CD16-, CD3- CD56brightCD69＋） in peripheral blood of URM patients, normal early pregnant women （NEP）, and normal nonpregnant women （NNP） were determined by flow cytometry. Results In URM group, the percentages of CD3＋HLA- DR＋ T, CD8＋HLA-DR＋ T cells, CD3- CD56＋, and CD56dim＋CD16＋NK cells were significantly higher than those in NEP group （P 〈 0.05） ; CD56brightCD16- NK cells were significandy lower than that in NEP and NNP group （P 〈 0.05） ; and that of CD4＋ T cells was significantly higher than that in NNP group （P 〈 0.05）. In NEP group, thepercentage of CD8＋ T cells was considerably higher than that in NNP group （P 〈 0.05） ; and that of CD4＋CD25＋ CD127dimTreg was significantly higher than those in NNP and URM groups （P 〈 0.05）. There was no significant difference in the percentages of CD3＋T cells and the ratio of CD4＋/CD8＋ among the three groups （P 〉 0.05）. ConClusions The increase of CD56dimCD16＋ NK cells, the activation of T cells, and the reduction of Treg cells may be the pathogenic immune basis of URM.