外泌体在子痫前期胎盘局部免疫平衡中的作用

Role of exosomes in local immune balance of placenta of pregnant women with preeclampsia

子痫前期(PE)是累及多个器官的妊娠期特有的综合征,在全球范围孕产妇死亡原因中排名第二。细胞外囊泡(EV)是细胞来源的脂质分子膜泡,分类为微囊泡、凋亡小体和外泌体。从PE患者中分离的外泌体参与免疫平衡失衡、胎盘形成缺陷和滋养层细胞功能障碍等机制,从而影响PE发生发展。外泌体内涵生物活性RNA和蛋白质等调节胎盘微环境中的相关介质,这些介质具有特异性免疫功能,可通过调节关键信号通路,进行胚胎着床的免疫调节和母胎沟通。研究表明,母胎使用来自间充质干细胞外泌体(MSC-exos)可以实现宫内免疫调节,在改善PE生理学和母婴健康方面有着巨大潜力。本文从PE的重要发病机制是母体-胎儿界面的免疫失衡出发,阐述外泌体参与PE的机制,并归纳近年来MSC-exos治疗PE的研究进展。

Preeclampsia(PE) is a syndrome specific to pregnancy that influences multiple organs and is the second leading cause of maternal death worldwide. Extracellular vesicles(EV) are a group of membrane vesicles of cell origin, including microvesicles, apoptotic bodies, and exosomes. Exosomes isolated from the pregnant women with PE are involved in immune balance imbalance, placental formation defects, and trophoblast cell dysfunction, thus affecting the occurrence and development of PE. Exosomes contain RNA and proteins and other related bioactive mediators that regulate the placental microenvironment. These mediators have specific immune functions and conduct immune regulation and maternal-fetal communication of embryo implantation by regulating key signaling pathways. Studies have shown that intrauterine immune regulation can be achieved with the use of mesenchymal stem cell-derived exosomes(MSC-exos) from maternal and fetal tissues, which has great potential in improving PE physiology and maternal and infant health. In this review, we focus on the local immune balance of mother-to-fetus interface as an important pathogenesis of PE to elucidate the mechanism of exosome involvement in PE. And we summarized the research progress of MSC-exos for treating PE in recent years.