稽留流产患者外周血中PD-1表达及其与Th1、Th2、Th17和Treg的关系

Expression of PD-1 in peripheral blood of missed abortion patients and its relationship with Th1,Th2,Th17,Treg

目的探讨稽留流产患者外周血中程序性细胞死亡因子(PD-1)表达及其与Th1、Th2、Th17和Treg的关系。方法选取2019年1月至2020年6月徐州医科大学附属医院收治的74例稽留流产患者作为稽留流产组进行前瞻性研究,并选取同期40例正常早孕者进行对照。检测两组对象的外周血PD-1表达水平,并使用流式细胞仪检测Th1、Th2、Th17和Treg表达水平,分析其外周血PD-1表达水平与Th1、Th2、Th17和Treg的关系。结果稽留流产组外周血PD-1水平和Th2细胞因子IL-4、IL-10含量为(2.06±0.55)%、(295.32±30.46)ng/L、(501.49±53.24)ng/L,均显著低于正常早孕组[(3.54±1.12)%、(514.37±38.52)ng/L、(715.22±62.34)ng/L],Th1细胞因子IL-2、IFN-γ含量、Th1/Th2为(332.45±41.27)ng/L、(3.49±1.13)ng/L、28.34±4.26,均显著高于正常早孕组[(273.58±21.46)ng/L、(2.03±0.52)ng/L、3.29±1.05],差异均有统计学意义(P<0.05)。稽留流产组Treg细胞水平为(4.39±1.25)%,低于正常早孕组[(5.32±1.27)%],Th17细胞水平、Th17/Treg为(5.28±1.34)%、1.24±0.35,高于正常早孕组[(4.26±1.33)%、0.83±0.27],差异均有统计学意义(P<0.05)。采用Pearson相关性进行分析,结果显示,稽留流产患者外周血PD-1表达与Th1、Th17细胞因子水平呈负相关(P<0.05),与Th2、Treg细胞因子水平呈正相关(P<0.05),与Th1/Th2、Th17/Treg表达呈负相关(P<0.05)。结论稽留流产患者外周血PD-1表达降低,与Th1/Th2和Th17/Treg表达呈负相关。稽留流产的发生与Th1、Th2、Th17和Treg失衡有关,可通过检测其外周血PD-1表达,了解患者机体免疫情况,进而为临床预测稽留流产提供指导依据。

Objective To explore the expression of programmed cell death factor(PD-1)in peripheral blood of patients with missed abortion and its relationship with Th1,Th2,Treg,Th17.Methods A total of 74 missed abortion patients admitted to the Affiliated Hospital of Xuzhou Medical University were selected from January 2019 to June 2020 as the the missed abortion group for prospective study,and 40 normal early pregnancy patients during the same period were selected for control group.The level of peripheral blood PD-1 in the two groups were expressed,and the expressions of Th1,Th2,Treg,Th17 were detected by flow cytometry,and the relationship between the level of PD-1 in peripheral blood and Th1,Th2,Treg,Th17 was analyzed.Results The levels of PD-1 and Th2 cytokines IL-4 and IL-10 in peripheral blood of missed abortion group were(2.06±0.55)%,(295.32±30.46)ng/L,and(501.49±53.24)ng/L,which were significantly lower those in the normal early pregnancy group[(3.54±1.12)%,(514.37±38.52)ng/L,(715.22±62.34)ng/L],the Th1 cytokines IL-2,IFN-γcontents and Th1/Th2 were(332.45±41.27)ng/L,(3.49±1.13)ng/L,28.34±4.26,which were significantly higher than those in the normal early pregnancy group[(273.58±21.46)ng/L,(2.03±0.52)ng/L,3.29±1.05],the differences were statistically significant(P<0.05).The level of Treg cells in the missed abortion group was(4.39±1.25)%,which was lower than that in the normal early pregnancy group[(5.32±1.27)%],and the levels of Th17 cells and Th17/Treg were(5.28±1.34)%,1.24±0.35,which were higher than normal early pregnancy group[(4.26±1.33)%,0.83±0.27],the differences were statistically significant(P<0.05).Pearson correlation was used to analyze the results.The results showed that the expression of PD-1 in peripheral blood of missed abortion patients was negatively correlated with the levels of Th1 and Th17 cytokines(P<0.05),and positively correlated with the levels of Th2 and Treg cytokines(P<0.05).It was negatively correlated with the expression of Th1/Th2 and Th17/Treg(P<0.05).Conclusion The expression of PD-1 in the peripheral blood of patients with missed abortion is negatively correlated with the expression of Th1/Th2,Treg/Th17.The occurrence of missed abortion is related to the imbalance of Th1,Th2,Treg,Th17,which can be detected by the expression of PD-1 in the peripheral blood,Understand the patient's immune status,and provide guidance for clinical prediction of threatened abortion.