妊娠期母体血清IL-35的表达水平及临床意义

Expression level and clinical significance of IL-35 in maternal serum during pregnancy

目的探讨抑制性细胞因子IL-35、IL-10和TGF-β在女性妊娠期和非妊娠期的表达水平．以及IL-35与复发性自然流产的相关性。方法通过酶联免疫吸附测定法分析120例正常妊娠、40例复发性自然流产史孕妇、40例产后健康妇女和40例非妊娠妇女的IL-35、IL-10、TGF-β的血清水平。相关性分析采用单因素logistic回归分析。结果健康妊娠女性血清IL-35水平显著高于非妊娠女性[333．6（59．32，1391）pg／ml VS 123．9（8．763，471．7）pg／ml；P〈0．001]。与非妊娠女性相比，TGF-β在妊娠早期显著升高[473．4（398．0，580．5）p∥mlvs379．7（311．0，441．3）pg／ml，P〈0．01]。血清IL-10水平在妊娠前后差异无统计学意义[8．602（5．854，12．89）pg／rnlVS9．339（5．691．12．07）pg／ml；P〉O．051。与健康妊娠早期的孕妇相比，复发性自然流产史孕妇的血清IL-35水平显著降低[220．4（4．951，702．0）pg／ml VS 386．5（64．37，1355）pg／ml；P〈O．05]。IL-35与习惯性流产的发生呈负相关（回归系数=-0．003，OR=0．997）。结论IL-35的血清水平在正常妊娠孕妇中增加，在复发性自然流产史孕妇中降低。IL-35是维持母胎免疫耐受的主动参与者，而不是IL-10或TGF-β。

Objective To analyze the levels of IL-35, IL-10 and TGF-β in women with or without pregnancy and to investigate the correlation between ｜L-35 and recurrent spontaneous abortion. Methods Levels of IL-35, IL-10 and TGF-β in serum were analyzed by enzyme-linked immunosorbent assay （ELISA） in 120 gravidas with normal pregnancy, 40 gravidas with a history of recurrent spontaneous abortion, 40 healthy postpartum women and 40 healthy non-pregnant women of childbearing age. Single factor logistic re- gression analysis was used for correlation analysis. Results The level of serum IL-35 in normal pregnancies was significantly higher than that in non-pregnant women [333.6 （59.32, 1 391 ） pg/ml vs 123.9 （8. 763, 471.7） pg/ml, P〈O. 001 ]. The level of TGF-βincreased significantly in the first trimester as compared with that in non-pregnant women [473.4 （398.0, 580.5） pg/ml vs 379.7 （311.0, 441.3） pg/ml, P〈 O. 013. No significant difference in the level of serum IL-10 was observed between gravidas and non-gravidas [ 8. 602 （5. 854, 12.89） pg/ml vs 9. 339 （5. 691, 12.07） pg/ml, P〉0.05 ]. The level of serum IL-35 in gravidas with recurrent spontaneous abortion was significantly lower than that in healthy gravidas in their first trimester [220.4 （4. 951, 702.0） pg/ml vs 386.5 （64.37, 1 355） pg/ml, P〈O. 05 ]. Serum IL-35 was negatively correlated with the occurrence of recurrent spontaneous abortion （ regression coefficient = -0.003, OR=0.997）. Conclusion The level of serum IL-35 increases in healthy gravidas, but decreases in gravi- das with recurrent spontaneous abortion. IL-35, rather than IL-10 or TGF-β, is recognized as an active play- er in maternal-fetal immune tolerance.