Th17/Treg细胞及其细胞因子在原因不明性复发性流产发病中的作用

The role of Th17 / Treg cells and cytokines in the pathogenesis of unexplained recurrent abortion

目的探讨原因不明复发性流产(URSA)女性患者外周血中Th17/Treg细胞及其相关细胞因子的表达和意义。方法选取2011年1月-2015年12月本院妇产科门诊收治的URSA患者32例和20例正常早孕女性,采用流式细胞术(FCM)检测外周血中Th17细胞和CD4^+CD25^+Treg细胞、Foxp3^+CD4^+CD25^+Treg细胞频数;同时检测血清中IL-17、IL-22、IL-10和IL-35细胞因子表达水平,荧光定量PCR检测外周血和蜕膜中Treg细胞的转录因子(Foxp3)和Th17细胞的转录因子ROR-γt的相对mRNA表达水平。结果 URSA组外周血Th17细胞的百分率高于正常对照组,CD4^+CD25^+Treg细胞和Foxp3^+CD4^+CD25^+Treg细胞的百分率低于正常对照组,差异均有统计学意义(P<0.05)。URSA组外周血的IL-22和IL-17A表达水平高于正常对照组,IL-10和IL-35表达水平低于正常对照组,差异均有统计学意义(P<0.05)。URSA组的外周血和蜕膜组织中的Treg细胞的转录因子Foxp3的mRNA表达低于正常对照组,Th17细胞的转录因子ROR-γt的mRNA表达高于正常对照组,差异均有统计学意义(P<0.05)。结论 Th17/Treg细胞平衡失调,可能是URSA发生的重要原因。

Objective To investigate the expression and significance of peripheral blood Th17 / Treg cells and their associated cytokines in patients with unexplained recurrent spontaneous abortion（ URSA）. Methods The frequency of Th17 cells and CD4^＋CD25^＋Treg cells,Foxp3^＋CD4^＋CD25^＋Treg cell in the peripheral blood of 32 patients with URSA（ experimental group）and 20 normal pregnant volunteers（ control group） by flow cytometry（ FCM）,who were selected from January 2011 to December2015 in the obstetrics and gynecology clinic of our hospital; the expression levels of serum IL-17,IL-22,IL-10 and IL-35 cytokine,and the expression levels of relative mRNA in Treg cell transcription factor（ Foxp3） and Th 17 transcription factor ROR-γt in peripheral blood and decidua were detected by the fluorescent quantitative PCR. Results URSA percentage of Th17 cells in peripheral blood was significantly higher than that of the control group,the percentage of URSA patients with peripheral blood CD4^＋CD25^＋Treg cells and Foxp3^＋CD4^＋CD25^＋Treg cell was significantly lower than the control group,and the difference was statistically significant（ P〈0. 05）. IL-22 and IL-17 A expression levels of URSA peripheral blood were significantly higher than the healthy control group,while IL-10 and IL-35 expression levels were significantly lower than the control group,and the difference were statistically significant（ P〈0. 05）. The mRNA expression of Treg transcription factor Foxp3 mRNA in peripheral blood cells and decidual tissue of URSA group was significantly lower than the healthy control group,while mRNA expression of Th17 cell transcription factor（ ROR-γt） was significantly higher than the control group,and the differences were statistically significant（ P〈0. 05）. Conclusion Th17 / Treg cell imbalance may be an important reason for the occurrence of URSA.