与早产临产相关的转录组学研究进展

Progress of Transcriptomics in Preterm Labor

早产是复杂的多因素综合征,是新生儿死亡的主要原因。早产一旦发生,并无切实有效的方法延长孕周。多年来研究人员一直致力于寻找早产的病理生理机制及有效的预测方法,但早产病理机制复杂,且需要母胎组织间的相互作用。母胎界面的转录组研究发现,妊娠期间过早的从抗炎状态转变为促炎状态,破坏母体先天性和适应性免疫平衡,从而发生早产。子宫肌层转录组研究也发现,分娩与炎症信号有关,包括与细胞因子、趋化因子和参与免疫反应的通路。而与妊娠相关组织的RNA通常会释放入母血,且RNA可直接反映来源组织的生理学信息。未来可以通过母体外周血中的细胞游离RNA来预测早产。但针对早产的研究仍存在一定的局限性,例如无法获得与胎龄相匹配的正常妊娠组织作为对照等问题,因而,寻找有效的能够预测早产的生物学标志物仍是未来一段时期的研究重点。

Preterm birth is a complex multifactorial syndrome that is the leading cause of neonatal death.Once preterm labor is initiated,there is no effective way to extend gestational ages.Over the years,researchers have been trying to find out the pathophysiological mechanism and effective prediction method of preterm labor,but the pathologic mechanism of preterm labor is complex and requires the interaction between maternal and fetal tissues.Transcriptome studies about the maternal-fetal interface have shown that premature birth occurs when an early shift from anti-inflammatory to proinflammatory status during pregnancy disrupts the mother’s innate and adaptive immune balance.Myometrial transcriptome studies have also found that labor is associated with inflammatory signals,including pathways associated with cytokines,chemokines,and immune responses.However,RNA from pregnancy-related tissues is usually released into maternal blood,and RNA can directly reflect the physiological information of the source of tissues.Therefore,cell free RNA in maternal peripheral blood can be used to predict preterm birth in the future.However,there are still some limitations in the study on preterm delivery,and it is impossible to obtain the normal pregnancy tissue matching with the gestational age as a control.Therefore,it is still the focus of future research to find effective biological markers that can predict preterm delivery.