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目的:研究孕早期不明原因反复自然流产(URSA)患者外周血、蜕膜组织CTLA-4及相关免疫分子的表达及其在母胎免疫调节中的作用。方法:采集10例正常育龄妇女(正常非孕组)黄体期、12例正常育龄妇女早孕期(正常妊娠组)和23例孕早期不明原因反复流产患者(URSA组)流产时的外周血,同时留取正常育龄妇女及反复流产患者早孕期行人工流产时蜕膜组织,应用流式细胞仪进行分析,比较CTLA-4、CD4+CD25+、CD80、CD86的表达水平。结果:CTLA-4在3组外周血中表达差异无统计学意义(P>0.05),正常妊娠组外周血淋巴细胞CD4+CD25+的表达显著高于URSA组与正常非孕组,差异有统计学意义(P<0.05),URSA组外周血淋巴细胞中CD80、CD86的表达显著高于正常妊娠组及正常非孕组,差异有统计学意义(P<0.05),正常妊娠组蜕膜组织CTLA-4、CD4+CD25+的表达显著高于URSA组,差异有统计学意义(P<0.05),URSA组蜕膜组织CD80、CD86的表达显著高于正常妊娠组(P<0.05)。结论:蜕膜组织淋巴细胞CTLA-4、CD4+CD25+、CD80、CD86的表达情况在母胎界面免疫耐受调控中起重要作用,外周血淋巴细胞CD4+CD25+、CD80、CD86的表达水平与孕早期反复流产有一定的相关性。
Objective: To study the expression of CTLA-4 and related immune molecules in peripheral blood and decidua of patients with unexplained recurrent spontaneous abortion (URSA) in early pregnancy and its role in the immunomodulation of maternal fetus. Methods: Peripheral blood samples from 10 normal women of reproductive age (normal non-pregnant group), 12 normal pregnant women (normal pregnancy group) and 23 pregnant women with unexplained recurrent miscarriage (URSA group) were collected at the same time Tissue decidual tissues were collected from normal women of reproductive age and recurrent miscarriage during the first trimester of pregnancy. The expression of CTLA-4, CD4 + CD25 +, CD80 and CD86 were compared by flow cytometry. Results: The expression of CTLA-4 in the peripheral blood of three groups showed no significant difference (P> 0.05). The expression of CD4 + CD25 + of peripheral blood lymphocytes in normal pregnancy group was significantly higher than that in URSA group and normal non-pregnant group (P <0.05). The expression of CD80 and CD86 in peripheral blood lymphocytes of URSA group was significantly higher than that of normal pregnancy group and normal non-pregnant group (P <0.05). CTLA- The expression of CD4 + CD25 + in URSA group was significantly higher than that in URSA group (P <0.05). The expression of CD80 and CD86 in decidual tissue of URSA group was significantly higher than that of normal pregnancy group (P <0.05). Conclusion: The expression of CTLA-4, CD4 + CD25 +, CD80 and CD86 in decidua lymphocytes plays an important role in the regulation of immunotolerance at the interface of maternal-fetal cells. The expression levels of CD4 + CD25 +, CD80 and CD86 in peripheral blood lymphocytes are similar to those in early pregnancy Repeated abortion has some relevance.