主动免疫治疗对不明原因习惯性流产患者辅助T细胞因子水平的影响

Influences of active immunotherapy on T helper cell type 1 and 2 cytokines in women with unexplained habitual abortion

目的 探讨主动免疫治疗对不明原因习惯性流产 (UHA)患者辅助T细胞 (Th) 1 /Th2型细胞因子水平的影响。方法 采用酶联免疫吸附法 ,检测 30例半年内接受过淋巴细胞主动免疫治疗的UHA患者 (治疗组 ) ,及 2 5例未经治疗的UHA患者 (未治疗组 ) ,外周血单个核细胞 (PBMC)经滋养细胞抗原刺激产生的Th1型细胞因子白细胞介素 (IL) 2、γ干扰素 (IFN γ)及Th2型细胞因子产生IL 4、IL 1 0水平。并选取 1 5例正常非妊娠妇女作为对照 (对照组 )。结果 (1 )在最佳诱导时间内 ,治疗组IL 2、IFN γ的水平分别为 (1 0 8± 37)ng/L、(1 1 0± 52 )ng/L ,明显低于未治疗组的 (2 2 3± 85)ng/L、(32 6±92 )ng/L(P值均 <0 .0 5) ;IL 4、IL 1 0水平分别为 (50± 1 1 )ng/L、(1 4 0± 37)ng/L ,明显高于未治疗组的(2 3± 1 1 )ng/L、(52± 2 8)ng/L(P值均 <0 .0 5)。未治疗组IL 2、IFN γ水平明显高于对照组的 (92± 32 )ng/L、(1 0 2± 35)ng/L(P值均 <0 .0 5) ;IL 4、IL 1 0水平低于对照组的 (62± 2 1 )ng/L、(1 50± 42 )ng/L(P值均 <0 .0 5)。治疗组与对照组各细胞因子水平比较 ,差异均无显著性 (P值均 >0 .0 5)。 (2 )治疗组30例患者治疗后半年内妊娠 2 6例 ,其中 8例自然流产 ,IL 2、IFN γ水平明显高于 1 8例妊娠?

Objective To investigate the influences of active immunotherapy on T helper cell (Th)1/Th2 type cytokines in women with unexplained habitual abortion(UHA) Methods A total of 55 patients with UHA were studied, including 30 cases after active immunotheraphy (AIT) and 25 cases without any therapy(NAIT). Fifteen cases of normal nonpregnant (NNP) women were selected as control group. Supernatants from trophoblast activated peripheral blood mononuclear cells (PBMC) of the three groups were tested by enzyme linked immunosorbent assay (ELISA) for interferon gamma (IFN γ), interleukin 2 (IL 2), IL 4, IL 10. Results (1) The levels of IL 2 and IFN γ in AIT group [(108±37) ng/L and (110 ±52) ng/L, respectively] were lower significantly than those in NAIT group[(223±85) ng/L and (326 ±92) ng/L, respectively]( P <0.05). The levels of IL 4 and IL 10 in AIT group [(50±11) ng/L and (140±37) ng/L, respectively] were higher than those in NAIT group[(23±11) ng/L and (52±28) ng/L]±( P <0.05). The levels of IL 2 and IFN γ in NAIT group were higher than those in NNP group[(92 ±32) ng/L and (102±35) ng/L]( P <0.05). The levels of IL 4 and IL 10 in NAIT group were lower than those in NNP group[(62±21) ng/L and (150±42) ng/L] ( P <0.05) .The level of every cytokine had no difference in AIT group and NNP group( P >0.05). (2) Twenty six women in AIT group got pregnant, but 8 women experienced pregnancy loss repeatedly whose IL 2?IFN γ levels were higher than those in other 18 women got successful pregnancy and IL 4,IL 10 levels lower than the latter. Conclusions UHA patients have Th1 type immunity to trophoblast and produce high level Th1 type cytokines which probably result in pregnancy loss. Active immunotheraphy could make a shift from Th1 to Th2 immunity, thus favoring the maintenance of pregnancy.