Zhou Wen-Hui, Dong Lin, Du Mei-Rong, Zhu Xiao-Yong, Li Da-Jin
Laboratory for Reproductive Immunology, Hospital and Institute of Obstetrics and Gynecology, Fudan University Shanghai Medical College, Shanghai 200011, China.
Reproduction. 2008 Mar;135(3):385-95. doi: 10.1530/REP-07-0063.
Immune regulation during pregnancy is complex, and thus an optimal therapy for pregnancy complications is always a big challenge to reproductive medicine. Cyclosporin A (CsA), a potent immunosuppressant, prevents rejection of allografts by hosts, but little is known about the modulating effect of CsA on the materno-fetal relationship. Here, pregnant CBA/J females mated with DBA/2 males as an abortion-prone model were administered with CsA on day 4.5 of gestation, and the pregnant CBA/J females mated with BALB/c males were established as successful pregnancy control. It was demonstrated that administration of CsA at the window of implantation significantly up-regulated the expression of CTLA-4, while down-regulating the levels of CD80, CD86, and CD28 at the materno-fetal interface in the CBA/J x DBA/2 abortion-prone matings, and the embryo resorption rate of the abortion-prone matings reduced significantly after CsA treatment, implying that modulation of costimulatory molecule expression by CsA might contribute to preventing the fetus from maternal immune attack. In addition, treatment with CsA induced enhanced growth and reduced cell apoptosis of the murine trophoblast cells. Together, these findings indicate that CsA has a beneficial effect on the materno-fetal interface in abortion-prone matings, leading to a pregnancy outcome improvement, which might provide new therapeutics for spontaneous pregnancy wastage.
孕期的免疫调节十分复杂,因此针对妊娠并发症的最佳治疗方法一直是生殖医学面临的重大挑战。环孢素A(CsA)是一种强效免疫抑制剂,可防止宿主对同种异体移植物的排斥反应,但CsA对母胎关系的调节作用却鲜为人知。在此,将妊娠第4.5天的CBA/J孕鼠与DBA/2雄鼠交配作为易流产模型,并给予CsA处理,同时将妊娠的CBA/J雌鼠与BALB/c雄鼠交配作为成功妊娠对照。结果表明,在植入窗口期给予CsA可显著上调CBA/J×DBA/2易流产交配组合中母胎界面CTLA-4的表达,同时下调CD80、CD86和CD28的水平,且CsA处理后易流产交配组合的胚胎吸收率显著降低,这意味着CsA对共刺激分子表达的调节可能有助于防止胎儿受到母体免疫攻击。此外,CsA处理可诱导小鼠滋养层细胞生长增强并减少细胞凋亡。总之,这些发现表明CsA对易流产交配组合中的母胎界面具有有益作用,可改善妊娠结局,这可能为自然流产提供新的治疗方法。