Kim Hye Ryoun, Park Ae Ja, Lee Mi Kyung, Cho Dong Hee
Department of Laboratory Medicine, Chung-Ang University College of Medicine, Korea.
Korean J Lab Med. 2006 Jun;26(3):198-203. doi: 10.3343/kjlm.2006.26.3.198.
Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive spontaneous abortion before 20 gestational weeks. But, 40-50% of RSA still remain "unex-plained". Cytokines seem to play a critical role in the pathogenesis of unexplained RSA, and Th1 cytokines have been shown to exert deleterious effects on pregnancy. NK cytotoxicity has been reported to be predictive of subsequent abortion in women who had unexplained recurrent abortions. The aim of this study was to investigate immunophenotypic characteristics of peripheral blood mononu-clear cells and evaluate Th1 cytokine (TNF-alpha) production in women with RSA.
The study group comprised 93 women with RSA, and the control group consisted of 40 healthy pregnant women. The population of CD56/CD16 cells was observed by using a two-color scattergram in FACScan (Becton Dickinson, San Jose CA, USA). Concentration of TNF-alpha was measured by an enzyme-linked immunoabsorbant assay (ELISA) using commercial kits (NEOGEN corporation, Lexington KY, USA).
The percentage of CD56+/CD16-cells were significantly higher (P<0.05) in the patients with RSA (13.40+/-7.95%) than in the pregnant control group (9.12+/-3.93%). We observed a significantly higher level of TNF-alpha (medians: 85.59+/-8.29 pg/mL versus 44.80+/-9.78 pg/mL; P<0.05) in RSA women compared to controls.
This study indicates that an increased proportion of CD56+/CD16-mononuclear cells and increased level of serum TNF-alpha are related to RSA. Thus, the two factors could be used as an indicator of subsequent successful implantation and maintenance of gestation.
复发性自然流产(RSA)被定义为在妊娠20周前连续发生三次或更多次自然流产。但是,40%-50%的RSA病例仍属“不明原因”。细胞因子似乎在不明原因RSA的发病机制中起关键作用,并且已表明Th1细胞因子对妊娠有有害影响。据报道,NK细胞毒性可预测不明原因复发性流产女性随后的流产情况。本研究的目的是调查RSA女性外周血单个核细胞的免疫表型特征并评估Th1细胞因子(肿瘤坏死因子-α)的产生情况。
研究组包括93例RSA女性,对照组由40例健康孕妇组成。使用FACScan(美国加利福尼亚州圣何塞市贝克顿·迪金森公司)中的双色散射图观察CD56/CD16细胞群体。使用商用试剂盒(美国肯塔基州列克星敦市NEOGEN公司)通过酶联免疫吸附测定(ELISA)测量肿瘤坏死因子-α的浓度。
RSA患者中CD56+/CD16-细胞的百分比(13.40±7.95%)显著高于妊娠对照组(9.12±3.93%)(P<0.05)。我们观察到,与对照组相比,RSA女性的肿瘤坏死因子-α水平显著更高(中位数:85.59±8.29 pg/mL对44.80±9.78 pg/mL;P<0.05)。
本研究表明,CD56+/CD16-单核细胞比例增加和血清肿瘤坏死因子-α水平升高与RSA有关。因此,这两个因素可作为随后成功着床和维持妊娠的指标。