米非司酮对药物流产患者外周血中差异基因表达研究

Effect of mifepristone on differential gene expression in peripheral blood of patients with medical abortion

目的研究米非司酮对药物流产患者外周血中Th1/Th2型细胞因子干扰素-γ(IFN-γ)、IL-2、IL-5、IL-6、IL-10以及细胞因子EDN1、EDNRA、EDNRB、NOS1、NOS2、NOS3、VEGF在药物流产过程中的表达变化。方法收集2014年4~7月就诊于天津医科大学总医院妇产科月经延迟7d以内要求药物流产的孕妇,随机分为两组。A组(5例):第1天口服米非司酮100mg,于2d后口服600μg米索前列醇;B组(6例):第1天口服米非司酮200mg,于2d后口服200μg米索前列醇。两组均分别在服米非司酮前和服米非司酮48h后收集受试者的外周血,采用qRT-PCR方法检测各基因在全血中的mRNA表达水平。结果与同组服用米非司酮前相比较,A组服用米非司酮后EDN1水平显著上调(P<0.05),上调至服药前的(2.19±1.20)倍,而B组服用米非司酮后EDN1水平显著下调(P<0.05),下调至服药前的(0.49±0.15);A组服用米非司酮后VEGF水平显著上调至服药前的(1.22±0.43)倍(P<0.05),而B组服用米非司酮后VEGF水平显著下调(P<0.05),下调至服药前的(0.72±0.14);A组和B组中,服用米非司酮前后IFN-γ水平差异无统计学意义(P>0.05)。结论在药物流产过程中不同剂量的米非司酮可能存在不同的作用机制;EDN1基因和VEGF基因可能在米非司酮药物流产过程中起着重要的作用。

Objective：To explore the expression changes of the peripheral blood-derived Th1/Th2 type cytokines including interferon-γ（IFN-γ）,IL-2,IL-4,IL-5,IL-6,IL-10 and cytokines EDN1,EDNRA,EDNRB,NOS1,NOS2,NOS3 and VEGF in the women with medical abortion by using two doses of mifepristone.Methods：The subjects were randomly divided into two groups：group A（100mg mifepristone on day1 orally,600μg misoprostol on day 3orally）,group B（200 mg mifepristone on day 1orally,200μg misoprostol on day 3orally）.The qRT-PCR were used to detect the expression of each mentioned gene in whole blood from women with medical abortion before（0hour）and after taking mifepristone（48hours）.Results：The expression level of EDN1 mRNA in group A was significantly increased in contrast to the baseline level（2.19±1.20,P〈0.05）,while the expression level of EDN1 mRNA in group B was significantly decreased（0.49±0.15,P〈0.05）.The expression level of VEGF mRNA in group A was significantly increased in contrast to the baseline level（1.22±0.43,P〈0.05）,while the expression level of VEGF mRNA in group B was significantly decreased（0.72±0.14,P〈0.05）.The expression level of IFN-γmRNA was not significantly changed in contrast to the baseline level in both groups（P〉0.05）.Conclusions：The different underlying mechanisms may be responsible for the women with medical abortion using two doses of mifepristone.EDN1 and VEGF may play vital roles in mifepristone induced abortion.