Saifi Bita, Rezaee Seyed Abdolrahim, Tajik Nader, Ahmadpour Mahmood Erfanian, Ashrafi Mahnaz, Vakili Rosita, SoleimaniAsl Sara, Aflatoonian Reza, Mehdizadeh Mehdi
Department of Anatomical Sciences, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran;
Immunology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;
Reprod Biomed Online. 2014 Oct;29(4):481-9. doi: 10.1016/j.rbmo.2014.06.008. Epub 2014 Jul 10.
Unexplained recurrent spontaneous abortion (RSA) might be caused by the mother's immunological rejection of the fetus. In this cross-sectional study, the percentage of T helper 17 (Th17), T regulatory (Treg) cells and their cytokines as the main players of immunomodulation in peripheral blood lymphocytes during the luteal phase of 20 women with unexplained RSA were compared with 20 normal non-pregnant women. The percentage of Treg cells in the former was significantly lower compared with controls. The percentage of Th17 cells in the former was higher than controls. Expression of IL-23, IL-17, IL-6 cytokines in the former was significantly higher than controls, but the higher expression of IL-21 was not significant. The gene expression of TGF-β and FoxP3 in the former was lower than controls. Significant positive correlations were found between the percentage of Th17 cells with IL-23, IL-6 and IL-17 and between expression of IL-23 and IL-6 and IL-17. IL-6 gene expression showed a significant positive correlation with IL-17. Therefore, imbalance of Th17-Treg cells and the consequent changes in cytokine expression might be implicated in the pathogenesis of unexplained RSA and may provide new insight into the immunoregulatory events at the maternal-fetal interface.
不明原因复发性自然流产（RSA）可能是由母亲对胎儿的免疫排斥反应引起的。在这项横断面研究中，将20例不明原因RSA患者黄体期外周血淋巴细胞中作为免疫调节主要参与者的辅助性T细胞17（Th17）、调节性T（Treg）细胞及其细胞因子的百分比与20例正常未孕女性进行了比较。前者Treg细胞的百分比显著低于对照组。前者Th17细胞的百分比高于对照组。前者白细胞介素-23（IL-23）、白细胞介素-17（IL-17）、白细胞介素-6细胞因子的表达显著高于对照组，但白细胞介素-21的较高表达无统计学意义。前者转化生长因子-β（TGF-β）和叉头框蛋白3（FoxP3）的基因表达低于对照组。Th17细胞百分比与IL-23、IL-6和IL-17之间以及IL-23与IL-6和IL-17的表达之间存在显著正相关。IL-6基因表达与IL-17呈显著正相关。因此，Th17-Treg细胞失衡以及随之而来的细胞因子表达变化可能与不明原因RSA的发病机制有关，并可能为母胎界面的免疫调节事件提供新的见解。
