环孢素A对不明原因复发性流产患者外周血IFN-γ、TNF-α的调控

Effect of cyclosporin A on IFN-γ and TNF-α in peripheral blood of patients with unexplained recurrent miscarriage

目的探讨环孢素A(CsA)对不明原因复发性流产(uRM)患者外周血干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)表达的影响。方法收集79例正常育龄期妇女的外周血标本,采用流式细胞仪检测其外周血CD3^+CD4^+T细胞中IFN-γ、TNF-α的表达水平,制定正常参考范围。入选36例IFN-γ、TNF-α表达量异常升高的uRM患者,于月经第1天口服CsA50mg,2次/d,直至黄体中期;收集uRM患者治疗前后的外周血,采用流式细胞仪检测IFN-γ、TNF-α的表达水平并进行比较。结果正常育龄期妇女外周血CD3^+CD4^+T细胞中IFN-γ、TNF-α的表达水平呈正态分布,以百分位数P10~P90(分别为6.7%~30.5%,12.6%~41.0%)作为正常参考范围。IFN-γ和/或TNF-α异常升高的uRM患者服用CsA后,其表达量均显著降低[IFN-γ:(36.7±9.3)%vs.(28.5±11.0)%,TNF-α:(52.8±7.2)%vs.(40.9±13.8)%,P<0.01]。结论CsA可以下调uRM患者外周血中IFN-γ、TNF-α的表达量,但其具体机制尚需进一步研究。

Objective：To explore the effect of cyclosporin A（CsA）on the expression of IFN-γand TNF-αin peripheral blood of patients with unexplained recurrent miscarriage（uRM）.Methods：The percentage of IFN-γ＋and TNF-α＋CD3＋CD4＋T cells from peripheral blood of 79 healthy women were analyzed by flow cytometry for developing a normal reference range.Thirty six patients with uRM characterized by increased expression of IFN-γand/or TNF-α were recruited.The patients were given the treatment of CsA,50 mg twice a day,from the first day of menstruation to luteal phase.The expression of IFN-γand TNF-αof the patients were determined by flow cytometry and compared before and after the treatment.Results：The expression levels of IFN-γ＋CD3＋CD4＋T cells and TNF-α＋CD3＋CD4＋T cells in peripheral blood of healthy women were normal distribution.The 10 th and 90 th percentiles were 6.7% 30.5% and 12.6% 41.0% respectively as the normal reference range.The expression of both IFN-γ[（36.7±9.3）% vs.（28.5±11.0）%]and TNF-α [（52.8±7.2）% vs.（40.9±13.8）%]in uRM patients were significantly decreased after the treatment（P〈0.01）.Conclusions：The treatment of CsA can reduce the expression of IFN-γand TNF-α,but its specific mechanism still needs further investigation.