NLRC5和Caspase-1在胎膜早破合并组织学绒毛膜羊膜炎患者中的表达及临床意义

Expression and Significance of NLRC5 in Patients with Premature Rupture of Fetal Membranes and Histologic Chorioamnionitis

目的:探讨核苷酸结合寡聚化结构域样受体5(NLRC5)和半胱天冬梅-1(Caspase-1)在胎膜早破(PROM)合并组织学绒毛膜羊膜炎(HCA)患者中的表达及临床意义。方法:选取2021年8月至2022年1月徐州医科大学附属徐州妇幼保健院就诊的PROM患者和同期足月正常剖宫产孕妇作为研究对象。根据是否诊断PROM、胎膜破裂时间、胎膜组织病理检查结果分为5组:未足月胎膜早破(PPROM)合并HCA组(PPROM+HCA组,(印)n(正)=30)、足月胎膜早破(TPROM)合并HCA组(TPROM+HCA组,(印)n(正)=32)、PPROM未合并HCA组(PPROM组,(印)n(正)=30)、TPROM未合并HCA(TPROM组,(印)n(正)=28)、足月正常剖宫产孕妇(对照组,(印)n(正)=30)。收集入院时孕妇的血清样本以及分娩时新鲜胎膜组织标本,用酶联免疫吸附(ELISA)法、免疫组化法、实时荧光定量PCR(qRT-PCR)检测NLRC5及Caspase-1表达水平和定位,用线性相关分析NLRC5和Caspase-1之间的相关性。结果:PPROM+HCA组、TPROM+HCA组孕妇血清和胎膜组织中NLRC5、Caspase-1的含量较其他3组显著增加((印)P(正)<0.05);其他3组之间比较差异无统计学意义((印)P(正)>0.05)。PPROM+HCA组、TPROM+HCA组胎膜组织中NLRC5和Caspase-1的蛋白及mRNA的表达较其他3组显著增加((印)P(正)<0.05);其他3组比较差异无统计学意义((印)P(正)>0.05)。PPROM+HCA组、TPROM+HCA组孕妇血清NLRC5、Caspase-1水平与胎膜组织中NLRC5 mRNA、Caspase-1 mRNA相对表达量呈正相关(r>0,(印)P(正)<0.05)。结论:血清中NLRC5与Caspase-1的浓度及胎膜组织中两者的mRNA表达呈一致性变化,NLRC5和Caspase-1参与了PROM合并HCA的发生。

Objective:By measuring the expression NLRC5 and Capsase-1 in maternal blood and fetal membrane tissue of patients with premature rupture of membranes and normal pregnant women, to explore its role in premature rupture of membranes and provide theoretical and experimental basis for clinical treatment.Methods:120 patients with premature rupture of membranes(PROM)diagnosed in Xuzhou Maternal and Child Health Hospital affiliated to Xuzhou Medical University from August 2021 to January 2022 were selected as the study group.30 pregnant women with normal term delivery without histological chorioamnionitis(HCA)were selected as the control group.According to the histopathological findings of membranes, the study group was divided into Preterm premature rupture of membranes(PPROM)combined with HCA.Term premature rupture of membranes(TPROM)combined with HCA.PPROM without HCA.TPROM does not merge HCA.Serum samples of pregnant women at admission and fresh fetal tissue samples at delivery were collected.Serum NLRC5 and Caspase-1 levels were detected by ELISA.The localization and expression of NLRC5 and Caspase-1 proteins in fetal tissue was detected by immunohistochemistry.The mRNA expression levels of NLRC5 and Caspase-1 in fetal tissue were detected by real-time quantitative PCR.Results:NLRC5 and Caspase-1 in maternal blood of PPROM+HCA group and TPROM+HCAgroup were significantly higher than those of the control group and the study groups without HCA(P<0.05).There were no significant differences among the other three groups(P>0.05).The expression of NLRC5 and Caspase-1 protein in fetal membranes of PPROM+HCA group and TPROM+HCA group were significantly higher than those of the control group and the study groups without HCA(P<0.05);There were no significant differences among the other three groups(P>0.05).The expression of NLRC5 and Caspase-1 mRNA in fetal membranes of PPROM+HCA group and TPROM+HCA group were significantly higher than those of the control group and the study groups without HCA(P<0.05);There were no significant differences among the other three groups(P>0.05).The concentration of NLRC5 and Caspase-1 in serum and their mRNA expression in fetal membrane showed consistent changes in PPROM+HCA group and TPROM+HCA group.Conclusion:The increased expression of NLRC5 and Caspase-1 mightrelated to the development of HCA.