复发性流产患者胎盘滋养细胞凋亡及Fas、FasL表达的研究

Study on Apoptosis and Expression of Fas?FasL in Placental Trophoblasts of Patients with Recurrent spontaneous Abortion

目的 :通过比较正常早孕妇女和复发性流产 (RSA)患者胎盘绒毛滋养细胞凋亡及Fas、FasL表达 ,进一步从细胞及分子水平探讨复发性流产的发病机理。方法 :应用免疫组织化学SP方法 ,测定 30例RSA患者和 2 5例正常早孕妇女胎盘绒毛滋养细胞Fas和FasL基因蛋白的表达 ,并通过MIAS 2 0 0 0医用彩色病理图像免疫组化测量系统对其表达进行半定量分析 ,其结果用平均灰度表示 ;同时应用DNA缺口原位末端标记技术 (TUNEL法 )测定两组胎盘绒毛滋养细胞凋亡情况。结果 :RSA组患者胎盘绒毛FasL的表达低于正常组 ,差异有显著性 (P <0 0 5 ) ;而Fas表达两组比较差异无显著性 (P >0 0 5 ) ,胎盘绒毛细胞滋养细胞及合体滋养细胞的凋亡指数 ,RSA组明显高于正常组 ,差异有非常显著性 (P<0 0 1)。结论 :细胞凋亡的增加可能是RSA发生的一个重要病理过程 ,且RSA患者胎盘绒毛滋养细胞表面FasL表达减少 ,导致母胎间免疫耐受的破坏 ,引起异常的免疫反应可能是RSA发病的重要机制。

Objective:To study the etiological miachnism of recurrent spontaneous abortion (RSA) by determining apoptosis and expression of Fas and FasL in placental trophoblasts of patients with RSA. Methods:Immuno-histochemistry staining(SP)was used to detect the expression of Fas and FasL in placentas of 30 women with RSAs and 25 women with normal first-trimester pregnancies. Medical color-image measure system for immune-histochemistry was used for semiquantitative analysis. Apoptosis was detected by using DNA in situ terminal deoxynuclotidyl transferas-mediated dUTP-biotin nick ending labeling(TUNEL). Results:FasL expression of the villus trophoblasts in the RSA group was less than that of the control group(P<0.05). Fas expression had no significant difference between two groups (P>0.05). In RSA group, apoptotic index(AI) of cytotrophoblasts and syncytrophoblasts was significantly higher than that of control group(P<0.01). Conclusions:The increment of apoptosis may be an important pathologic process in RSA.Meanwhile, the decreased expression of FasL on placental trophoblasts, which destroy the immunologic tolerance between the mother and the fetus,may be one of the important pathogenesis of RSA.