原因不明复发性流产患者再次妊娠早孕期HMGB1、单核细胞上Tim-3、PD-1表达与免疫失衡的关系

The relationship between the expression of HMGB1,Tim-3,PD-1 and immune imbalance in the peripheral blood of URSA patients during the second trimester

目的探讨原因不明复发性流产(URSA)患者再次妊娠早孕期外周血高迁移率蛋白B1(HMGB1)、单核细胞上T细胞免疫球蛋白黏蛋白结构域相关分子-3(Tim-3)、程序性细胞死亡因子-1(PD-1)表达与Th17/Treg平衡的关系。方法选取2018年1月至2019年2月在海口市妇幼保健院就诊的88例URSA早孕患者作为观察组,同时选取50例正常早孕女性作为对照组,检测并比较两组外周血HMGB1、单核细胞上Tim-3、PD-1表达水平及Th17、Treg细胞等。结果观察组外周血HMGB1水平为(103.29±34.40)ng/mL,明显高于对照组(P<0.05),而单核细胞上Tim-3、PD-1表达分别为(2.88±0.92)%和(2.65±0.90)%,明显低于对照组(P<0.05);观察组外周血Th17和Th17/Treg分别为(3.03±0.89)%和(0.94±0.32),明显高于对照组(P<0.05);而观察组Treg为(3.24±0.72)%,明显低于对照组(P<0.05);观察组和对照组外周血CD3+、CD4+和CD8+T比较,差异无统计学意义(P>0.05);HMGB1与Th17、Th17/Treg呈正相关(r=0.344、0.302,P<0.05),而与Treg呈负相关(r=-0.336,P<0.05)。结论URSA早孕期患者外周血HMGB1水平升高,而单核细胞上Tim-3和PD-1表达下调,其中HMGB1与Th17/Treg平衡紊乱有关。

Objective To investigate the relationship between Th17/Treg balance and the expression of high mobility group protein B1(HMGB1),T cell immunoglobulin and mucin domain-containing molecules-3(Tim-3),programmed cell death factor-1(PD-1)in peripheral blood of patients with early pregnancy of patients with unexplained recurrent spontaneous abortion(URSA).Methods From January 2018 to February 2019,88 early pregnancy patients with URSA in Haikou Maternal and Child Health Hospital were selected as the observation group,and 50 normal early pregnancy women were selected as the control group.The expression levels of Tim-3 and PD-1 in HMGB1 and mononuclear cells,as well as Th17 and Treg cells in peripheral blood of the two groups were detected and compared.Results HMGB1 in peripheral blood of the observation group was(103.29±34.40)ng/mL,which was significantly higher than that of the control group(P<0.05),while the expression of Tim-3 and PD-1 in monocytes were(2.88±0.92)%and(2.65±0.90)%,which were significantly lower than that of the control group(P<0.05);Th17 and Th17/Treg in peripheral blood of the observation group were(3.03±0.89)%and(0.94±0.32),which were significantly higher than that of the control group(P<0.05),while Treg was(3.24±0.72)%,which was significantly lower than that of the control group(P<0.05);there were no significant difference in CD3+,CD4+and CD8+T between the observation group and the control group(P>0.05);HMGB1 were positively correlated with Th17 and Th17/Treg(r=0.344 and 0.302,P<0.05),while negatively correlated with Treg(r=-0.336,P<0.05).Conclusions The levels of HMGB1 in peripheral blood of URSA patients in early pregnancy are increased,while the expressions of Tim-3 and PD-1 in monocytes are down-regulated,which HMGB1 is related to the imbalance of Th17/Treg.