树突状细胞在人正常子宫内膜的表达及周期性变化研究

Study on the endometrial dendritic cells populations during the normal menstrual cycle

目的研究树突状细胞(DCs)在人正常子宫内膜的表达及周期性变化。方法免疫组织化学法分别测定CD1a、CD83阳性细胞在40例人正常子宫内膜的表达(增生期20例,植入窗期20例),结合血清雌二醇(E2)、黄体酮(P)水平,分析DCs表达水平与E2、P的相关性。结果增生期子宫内膜CD1a^+DCs阳性率为90%(18/20),植入窗期CD1a^+DCs阳性率为100%(20/20),所有标本均未检测到CD83表达。DCs数量随月经周期变化而变化,植入窗期CD1a^+DCs细胞密度为(18.2±5.76)个/mm^2,显著高于增生期子宫内膜CD1a^+DCs细胞密度(6.5±4.05)个/mm^2(P<0.05)。子宫内膜DCs数量与血清P水平具有相关性(r=0.630,P<0.01)。结论植入窗期子宫内膜CD1a^+DCs数量增加可促进母胎免疫耐受。

Objective To investigate the number and distribution of dendritic cells in normal endometrium of reproductive age during the normal menstrual cycle. Methods Normal endometrial samples were collected from 40 women of reproductive age. Z0 endometrium samples at the proliferative phase （day 6th to 10th） and 20 endometrium samples at the ＂window of implantation＂ （day 20th to 24th） were obtained. These patients underwent intrauterine exploration before IVF and ET resulting from tubal resection or male factor infertility. Endometrial tissue was collected with a pipelle aspirator. Sections were stained with hematoxylin-eosin （HE） to identify the morphological characteristics of endometrial tissues. The Envision two-step immunohistochemical staining technique was used to detect the expression of CD1a and CD83 in the endometrium. Normal human skin and tonsil were used as positive control tissues for CD1a and CD83, respectively. The serum levels of ovarian steroid hormones were measured to analyze their relationship with the expression of CD1a and CD83. Results CD1a^＋ DCs were Found in all samples of ＂window of implantation＂ and most samples of the proliferative phase （18/20,90 %）. DCs showed irregular shape with different processes and were bully in cell membrane, mainly in stroma around grand and blood vessels. The density of CD1a^＋ DCs at the ＂window of implantation＂ were （18. 2±5. 76）cetls/mm^2 ,significantly higher than that at the proliferative phase [-（6.52±4. 05）celts/mm^2 , P〈0. 05]. CD83 was considered as the marker for mature DCs. However, immunohistochemistry with specific antibody revealed no CD83^＋ DCs were found in human emdometrium in the present study. During the menstrual cycle,the expression of CD1a^＋ DCs in endometrium （the density of CD1a^＋ DCs） correlated with serum progesterone level（r= 0. 630, P〈0.01）. Serum estradiol showed no correlation with the density of CD1a＋ DCs（P〉0.05）. Conclusion Increased CD1a^＋ immature DCs at the ＂window of implantation＇ in endome, trium may play an important role in the establishment of maternal-fetal tolerance.