维生素D对复发性流产患者外周血自然杀伤细胞的调节作用

Modulatory effects of vitamin D on peripheral NK cells in patients with recurrent miscarriage

目的探讨维生素D对复发性流产(recurrent miscarriage,RM)患者外周血自然杀伤细胞(natural killer cells,NK)的调节作用。方法收集99例RM患者黄体中期的外周血,流式细胞术检测外周血NK细胞的数量和细胞毒性。根据患者体内维生素D水平将其分为三组:维生素D正常组(vitamin D normal,VDN)、维生素D不足组(vitamin D insufficiency,VDI)和维生素D缺乏组(vitamin D deficiency,VDD)。对维生素D缺乏和不足的RM患者补充1,25(OH)2D,分析维生素D补充对RM患者的NK细胞的调节作用。结果 CD3^-CD56^+NK细胞比例在三组间无显著差异(P>0.05)。VDI组中NK细胞毒性在效靶比(effector-to-target ratio,E:T)为50∶1(51.6±8.8 vs.45.3±12.4)(P<0.05)、25∶1(43.2±9.1 vs.35.8±11.8)(P<0.01)和12.5∶1(30.2±10.3 vs.23.0±10.6)(P<0.01)这三个条件下均显著高于VDN组。补充维生素D后,可显著降低E:T为50∶1(41.6±14.0 vs.51.0±10.5)(P<0.01)、25∶1(34.9±14.3 vs.43.1±10.8)(P<0.01)和12.5∶1(22.6±11.4 vs.29.9±10.7)(P<0.01)的NK细胞毒性。结论低水平维生素D的RM患者外周血NK细胞毒性增加,而补充1,25(OH)2D可在一定程度上降调NK细胞毒性。

Objective:To investigate the modulatory effects of vitamin D(VD)on peripheral blood natural killer(NK)cells in patients with recurrent miscarriage(RM).Methods:The Peripheral bloods of mid-luteal phase were collected from 99 patients with RM.The quantity and cytotoxicity of NK cells in peripheral blood were detected by flow cytometry.The RM patients were divided into three groups according to the levels of vitamin D:VD normal group(VDN),VD insufficiency group(VDI),and VD deficiency group(VDD).Meanwhile,1,25(OH)2D was supplemented to the RM patients with VD deficiency to observe the regulatory effect of VD supplementation on NK cells.Results:There was no significant difference in the percentage of CD3-CD56+NK cells among the three groups(P>0.05).The effector to target cell(E:T)ratio of NK cytotoxicity was 50∶1(51.6±8.8 vs.45.3±12.4,P<0.05),25∶1(43.2±9.1 vs.35.8±11.8,P<0.01)and 12.5∶1(30.2±10.3 vs.23.0±10.6,P<0.01)in the VD insufficiency group(VDI)were significantly higher than that in the VD normal group(VDN).After 1,25(OH)2 D supplementation,no significant difference in the percentage of CD3-CD56+NK cells was observed among the three groups.However,the effector to target cell(E:T)ratio of NK cytotoxicity was 50∶1(41.6±14.0 vs.51.0±10.5,P<0.01),25∶1(34.9±14.3 vs.43.1±10.8,P<0.01),12.5∶1(22.6±11.4 vs.29.9±10.7,P<0.01),which was significantly reduced with 1,25(OH)2 D supplementation.Conclusions:NK cytotoxicity is increased in peripheral blood of RM patients with low-level vitamin D.Supplementing of 1,25(OH)2D can reduce NK cytotoxicity to a certain extent.