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目的探讨原因不明复发性流产(URSA)女性患者外周血中Th17/Treg细胞及其相关细胞因子的表达和意义。方法选取2011年1月-2015年12月本院妇产科门诊收治的URSA患者32例和20例正常早孕女性,采用流式细胞术(FCM)检测外周血中Th17细胞和CD4~+CD25~+Treg细胞、Foxp3~+CD4~+CD25~+Treg细胞频数;同时检测血清中IL-17、IL-22、IL-10和IL-35细胞因子表达水平,荧光定量PCR检测外周血和蜕膜中Treg细胞的转录因子(Foxp3)和Th17细胞的转录因子ROR-γt的相对mRNA表达水平。结果 URSA组外周血Th17细胞的百分率高于正常对照组,CD4~+CD25~+Treg细胞和Foxp3~+CD4~+CD25~+Treg细胞的百分率低于正常对照组,差异均有统计学意义(P<0.05)。URSA组外周血的IL-22和IL-17A表达水平高于正常对照组,IL-10和IL-35表达水平低于正常对照组,差异均有统计学意义(P<0.05)。URSA组的外周血和蜕膜组织中的Treg细胞的转录因子Foxp3的mRNA表达低于正常对照组,Th17细胞的转录因子ROR-γt的mRNA表达高于正常对照组,差异均有统计学意义(P<0.05)。结论 Th17/Treg细胞平衡失调,可能是URSA发生的重要原因。
Objective To investigate the expression and significance of Th17 / Treg cells and related cytokines in peripheral blood of women with unexplained recurrent spontaneous abortion (URSA). Methods Thirty-two URSA patients and 20 normal pregnant women were enrolled in the obstetrics and gynecology clinic from January 2011 to December 2015. The levels of Th17 cells and CD4 ~ + CD25 ~ + Treg cells and Foxp3 ~ + CD4 ~ + CD25 ~ + Treg cells were detected by flow cytometry. The levels of IL-17, IL-22, IL-10 and IL-35 in serum were detected by real- (Treg cell transcription factor Foxp3) and Th17 cells ROR-γt relative mRNA expression levels. Results The percentage of Th17 cells in peripheral blood of URSA group was higher than that of normal control group. The percentage of CD4 ~ + CD25 ~ + Treg cells and Foxp3 ~ + CD4 ~ + CD25 ~ + Treg cells in URSA group were lower than those in normal control group P <0.05). The expression of IL-22 and IL-17A in peripheral blood of URSA group was higher than that of normal control group, while the expression of IL-10 and IL-35 was lower than that of normal control group (P <0.05). The mRNA expression of Foxp3, a transcription factor of Treg cells in peripheral blood and deciduas of URSA group was lower than that of normal control group, and the mRNA expression of ROR-γt in Th17 cells was higher than that in normal control group P <0.05). Conclusion The imbalance of Th17 / Treg cells may be an important cause of URSA.