HIF-1α、TLR 4与稽留流产妊娠滋养细胞凋亡的关系研究

Study on the relationship between HIF-1α,TLR 4 and apoptosis of trophoblasts in missed abortion

目的研究稽留流产患者绒毛组织中缺氧诱导因子1α(hypoxia inducible factor 1α,HIF-1α)、Toll样受体4(Toll like receptor 4,TLR 4)、Fas、FasL的表达、分布情况并进行相关性分析,探讨HIF-1α、TLR 4与稽留流产妊娠滋养细胞凋亡的关系。方法选取2017年1~8月于南通市第一人民医院妇科就诊的40例稽留流产患者为稽留流产组,同期行人工流产手术的正常妊娠孕妇40例为对照组。负压吸宫留取胎膜绒毛组织,采用HE染色及电镜检查,观察绒毛组织结构;酶联免疫吸附试验法检测绒毛组织中HIF-1α、TLR 4的浓度;免疫组织化学SP法检测绒毛组织中HIF-1α、TLR 4、Fas、FasL蛋白表达情况,并进行相关性分析。结果两组HE染色、ELISA检测、Fas/FasL蛋白表达、相关性分析4个方面比较,差异均有统计学意义(P<0.05);稽留流产组绒毛组织中HIF-1α、TLR 4、Fas和FasL表达均高于对照组,差异有统计学意义(P<0.05)。结论HIFlα、TLR 4、Fas/FasL在稽留流产发生过程中均有一定作用,TLR 4-NF-κB-HIF-1α通路所导致的缺氧和炎症反应与稽留流产的发生密切相关。

Objective To study the expression and distribution of hypoxia-inducible factor 1α(HIF-1α),Toll-like receptor 4(TLR 4),Fas,and FasL in the villi of missed abortion patients trophoblast apoptosis.Methods From January to August 2017,40 cases of missed abortion patients who were treated in the Gynecology Department of the First People's Hospital of Nantong City were selected as the missed abortion group,and 40 normal pregnant women who underwent artificial abortion at the same time were used as the control group.Negative pressure suction uterine retention of fetal membrane villi tissue,using HE staining and electron microscopy to observe the villi tissue structure;enzyme-linked immunosorbent assay(ELISA)method to detect the concentration of HIF-1αand TLR 4 in villi tissue;immunohistochemical SP method to detect expression of HIF-1α,TLR 4,Fas,FasL protein in villi tissue,and correlation analysis.Results There were significant differences in HE staining,ELISA detection,Fas/FasL protein expression and correlation analysis between the two groups(P<0.05).The expressions of HIF-1α,TLR 4,Fas and FasL in the villi of the abortion group were higher than in the control group,and the differences were statistically significant(P<0.05).Conclusion HIF-lα,TLR 4 and Fas/FasL all play a role in the occurrence of missed abortion.The hypoxia and inflammation caused by the TLR 4-NF-κB-HIF-1αpathway are closely related to the occurrence of missed abortion.