复发性自然流产过程中蜕膜自然杀伤细胞相关受体的作用机制研究进展

Research progress on mechanism of decidual natural killer cell related receptors in recurrent spontaneous abortion

复发性流产(RSA)是指和同一性伴侣有多次自发性流产,2020年我国专家共识建议将之定义为与同一个性伴侣连续2次或者2次以上,在妊娠28周前胚胎或者胎儿的丢失,这其中包括连续多次发生的生化妊娠。RSA的发病机制复杂多样,目前已被业界广泛认可的发病因素包括有遗传因素、内分泌因素、解剖学异常、感染因素及免疫因素等,其中免疫因素如T淋巴细胞、树突状细胞、自然杀伤(NK)细胞等在RSA的发生发展中的作用受到广泛关注与重视,尤其是NK细胞。NK细胞是人类免疫系统的重要组成部分,蜕膜NK细胞的特定表面分子在滋养层细胞的侵袭过程及妊娠期子宫螺旋动脉的重塑过程中起免疫调节作用,这在妊娠早期尤为重要。蜕膜NK细胞的功能受其表达的各种家族受体(NK细胞受体,NKR)传递的激活和抑制信号之间平衡的严格调控。本文针对蜕膜NK细胞相关受体在复发性自然流产过程中作用机制的研究进展进行综述。

Recurrent abortion(RSA)refers to multiple spontaneous abortions with the same sexual partner.In 2020,Chinese expert consensus suggested that it should be defined as the loss of embryo or fetus before 28 weeks of gestation with the same sexual partner for two or more times in a row,including the biochemical pregnancy that occurred several times in a row.The pathogenesis of RSA is complex and diverse,and the pathogenesis factors that have been widely recognized by the industry include genetic factors,endocrine factors,anatomical abnormalities,infectious factors and immune factors,among which the role of immune factors such as T lymphocytes,dendritic cells and natural killer(NK)cells in the occurrence and development of RSA has been widely concerned and attached importance,especially NK cells.NK cells are an important part of the human immune system.The specific surface molecules of decidual NK cells play an immunomodulatory role in the invasion of trophoblast cells and the remodeling of the uterine spiral artery during pregnancy,which is particularly important in the early pregnancy.The function of decidual NK cells is strictly regulated by a balance of activation and inhibition signals transmitted by the various families of receptors(NK cell receptors,NKRs)they express.This paper reviews the existing research progress on the mechanism of decidual NK cells related receptors in the process of recurrent spontaneous abortion.