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同种异体移植排斥反应、复发性流产和子痫前期之间的免疫学相似性——相同的基本机制?

Immunological analogy between allograft rejection, recurrent abortion and pre-eclampsia - the same basic mechanism?

作者信息

Wilczyński Jacek R

机构信息

Department of Gynecological Surgery, Polish Mother's Health Center Research Institute, Lodz, Poland.

出版信息

Hum Immunol. 2006 Jul;67(7):492-511. doi: 10.1016/j.humimm.2006.04.007. Epub 2006 May 4.

Abstract

There are still controversies concerning the role of immunological mechanisms engaged both in recurrent abortions (RA) and pre-eclampsia (PE). According to some opinions, recurrent miscarriage is comparable to organ-specific autoimmune disease. Analysis of immune reactions shows that graft rejection shares many similar mechanisms with RA and PE. This fact allows us to conclude that rejection of transplanted alloantigenic organs and pregnancy loss have probably the same evolutionary origin. Subsets and functions of immunocompetent cells (T CD4, suppressor gammadeltaT, cytotoxic T CD8, Treg, Tr1, uterine NK cells), over-activation of innate immunity (activation of NK cytotoxic cells, macrophages, neutrophils and complement), changes of Th1/Th2 cytokine balance (IL-2, IL-12, IL-15, IL-18, IFNgamma, TNFalpha vs. IL-4, IL-10, TGFbeta), importance of HLA-G molecule, CD200/CD200R interaction, over-expression of adhesion molecules, fgl2 prothrombinase activation and stimulation of IDO and HO expression, all suggest that RA and PE are syndromes of fetal allograft rejection, and not organ-specific autoimmune diseases. According to that supposition, an analogy might exist between acute graft rejection and recurrent abortion, and between chronic graft rejection and pre-eclampsia.

摘要

关于免疫机制在复发性流产(RA)和子痫前期(PE)中所起的作用,目前仍存在争议。一些观点认为,复发性流产类似于器官特异性自身免疫性疾病。对免疫反应的分析表明,移植排斥与复发性流产和子痫前期有许多相似的机制。这一事实使我们能够得出结论,移植的同种异体抗原器官的排斥反应和妊娠丢失可能具有相同的进化起源。免疫活性细胞(T CD4、γδT抑制细胞、细胞毒性T CD8、调节性T细胞、Tr1细胞、子宫自然杀伤细胞)的亚群和功能、固有免疫的过度激活(自然杀伤细胞毒性细胞、巨噬细胞、中性粒细胞和补体的激活)、Th1/Th2细胞因子平衡的变化(IL-2、IL-12、IL-15、IL-18、IFNγ、TNFα与IL-4、IL-10、TGFβ)、HLA-G分子的重要性、CD200/CD200R相互作用、黏附分子的过度表达、fgl2凝血酶原酶激活以及IDO和HO表达的刺激,所有这些都表明复发性流产和子痫前期是胎儿同种异体移植排斥综合征,而非器官特异性自身免疫性疾病。根据这一假设,急性移植排斥与复发性流产之间,以及慢性移植排斥与子痫前期之间可能存在相似之处。

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