补肾益气方调控TGF-β1对反复自然流产患者外周血Treg/Th17细胞平衡的影响

Effect of Bushen Yiqi formula on Treg/Th17 balance in women with recurrent spontaneous abortion by through regulating TGF-β1 expression

为探讨补肾益气方通过调控TGF-β1对反复自然流产(recurrent spontaneous abortion,RSA)患者外周血Treg和Th17细胞平衡的影响,选取了15例RSA患者,孕42d起诊断为正常宫内妊娠后服中药,在服药前以及服药一个月后以流式细胞术检测Treg和Th17细胞数量,ELISA方法检测外周血TGF-β1及IL-10、IL-17水平。结果显示,中药治疗后RSA患者外周血Treg数量上升至(5.94±1.37)%,明显高于服药前(3.45±0.93)%(P<0.05)。Th17细胞数量下降至(1.12±0.32)%,低于治疗前(2.61±0.70)%。中药治疗后,Treg/Th17细胞比值上升,从1.43±0.66升高至5.64±1.84%(P<0.05)。Treg相关细胞因子IL-10水平从(17.90±4.18)pg/ml上升至(28.80±7.18)pg/ml,Th17细胞相关细胞因子IL-17则从(45.83±4.15)pg/ml下降至(31.21±5.62)pg/ml,同时发现中药治疗后血TGF-β1水平从(192.73±13.97)pg/ml上升为(334.07±61.53)pg/ml(P<0.05),TGF-β1/IL-17比值从4.23±0.43提高至11.20±3.56,IL-10/IL-17比值从0.39±0.09上升至0.94±0.28(P<0.05),差异有统计学意义。以上结果表明补肾益气方能够调控Treg/Th17细胞平衡,改变母体细胞因子分泌状态,保护胎儿不被排斥,其机制可能与母体TGF-β1水平上调有关。

To investigate the effect of Bushen Yiqi formula on Treg/Th17 balance in patients suffered from recurrent spontane- ous abortion （RSA） and to make known whether it involved regulation of TGF-β1, we selected 15 pregnant women with RSA from our hospital. Patients were administered with herbs as soon as the intrauterine pregnancy was established by transvaginal ultrasound at week 6 of gestation. The blood from patients was collected respectively before herbs treatment and one month later after treatment for examination of the frequencies of Thl7 and Treg cells by FACS and the levels of TGF-β1, IL-10, and IL-17 by ELISA. The results revealed that the frequency of Treg cells was increased to （5.94± 1.37） % and that of Thl7 cells was decreased to （1.12± 0. 32）% in the patients compared with those one month agoETreg： （3.45±0.93）%, P〈0. 05; Thl7 ： （2.61±0.70） %, P〈0.05]. After treatment, the balance between Treg and Thl7 was changed, inducing the ratio of Treg/Thl7 up to （5.64±1.84）% compared with that before treatment [（1.43±0.66）%, P〈0.05]. And the level of IL-10 increased from （17.90±4.18） pg/ml to （28.80±7. 18） pg/ml （P〈 0.05）, while the amount of IL-17 was decreased form （45.83±4.15） pg/ml to （31.21±5.62） pg/ml （P〈 0.05）. The increasing trend also could be seen in the ratio of sTGF-β1/ IL-17（4.23±0.43,pre-treatment and 11.20±.56, post-treatment P〈 0.05） and IL-10/IL-17（0. 39±0. 09, pre-treatment and 0.94± 0. 28, post-treatmentP〈 0.05）. At the same time, we found that the level of TGF-β1 has been improved from （192.73 ± 13.97） pg/ml to （334.07± 61.53） pg/ml（P〈 0.05）. These results indicate that the Bushen Yiqi formula can regu- late the balance between Treg and ThlT, and the amount of cytokines to protect the fetus from rejection, which may have something to do with the increasing level of TGF-β1.