Wilczyński Jacek R, Tchórzewski Henryk, Banasik Małgorzata, Głowacka Ewa, Wieczorek Artur, Lewkowicz Przemysław, Malinowski Andrzej, Szpakowski Marian, Wilczyński Jan
Department of Obstetrics and Gynecology, Military Medical Academy, Lodz, Poland.
Eur J Obstet Gynecol Reprod Biol. 2003 Jul 1;109(1):8-15. doi: 10.1016/s0301-2115(02)00350-0.
Excessive Th1 activity in peripheral blood plays a probable role in the pathogenesis of preeclampsia. The aim of the study was to investigate whether disturbed local immune reactions are also present in decidua.
Flow cytometric analysis of CD3, CD19, CD56/CD16, CD4, CD8, CD4/CD29, CD4/CD45RA, CD4/CD45RO, CD8/CD28, CD3/CD69 lymphocyte subsets isolated from third trimester decidua of pregnants with preeclampsia (n=21) and pregnant controls (n=11) subjected to elective caesarean sections. Spontaneous and phytohemaglutynine stimulated "in vitro" secretion of IL-2, IL-4, IL-6, IL-10, IL-12, IFN-gamma and TGF-beta by decidual lymphocytes was studied by ELISA. For the statistical significance of differences between the groups the U Mann-Whitney test was performed (confidence interval P<0.05).
Preeclamptic patients were characterized with an increased percentage of the CD3-/CD56+CD16+, CD8+/CD28+ and decreased percentage of CD3+, CD19+, CD4+/CD45RA+ lymphocytes. The profile of secreted cytokines shifts in favor of Th1 activity (extremely high IFN-gamma and low IL-6 and IL-10 secretion). Decidual IL-12 secretion in preeclamptic patients is decreased compared to controls.
Changes in NK and T lymphocyte subsets followed with Th1 cytokine IFN-gamma over-activity, could affect local immunoregulatory mechanisms in third trimester decidua of preeclamptic patients.
外周血中Th1活性过高可能在子痫前期的发病机制中起作用。本研究旨在调查蜕膜中是否也存在局部免疫反应紊乱。
对子痫前期孕妇（n = 21）和择期剖宫产的妊娠对照组孕妇（n = 11）孕晚期蜕膜中分离出的CD3、CD19、CD56/CD16、CD4、CD8、CD4/CD29、CD4/CD45RA、CD4/CD45RO、CD8/CD28、CD3/CD69淋巴细胞亚群进行流式细胞术分析。通过酶联免疫吸附测定法研究蜕膜淋巴细胞自发和经植物血凝素刺激后的白细胞介素-2、白细胞介素-4、白细胞介素-6、白细胞介素-10、白细胞介素-12、γ-干扰素和转化生长因子-β的“体外”分泌情况。采用U曼-惠特尼检验对两组间差异的统计学显著性进行分析（置信区间P<0.05）。
子痫前期患者的特征为CD3-/CD56+CD16+、CD8+/CD28+淋巴细胞百分比增加，CD3+、CD19+、CD4+/CD45RA+淋巴细胞百分比降低。分泌的细胞因子谱向有利于Th1活性的方向转变（γ-干扰素分泌极高，白细胞介素-6和白细胞介素-10分泌低）。与对照组相比，子痫前期患者蜕膜白细胞介素-12分泌减少。
自然杀伤细胞和T淋巴细胞亚群的变化以及Th1细胞因子γ-干扰素的过度活性可能影响子痫前期患者孕晚期蜕膜中的局部免疫调节机制。
