Dabagh-Gorjani Feryal, Anvari Fahimeh, Zolghadri Jaleh, Kamali-Sarvestani Eskandar, Gharesi-Fard Behrouz
Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, e-mail:
Iran J Immunol. 2014 Dec;11(4):233-45.
Preeclampsia (PE) is one of the most complex and life-threatening pregnancy disorders and is considered as a major cause of mortality among mothers and fetuses worldwide. Although the exact etiology of PE is not well known several lines of evidence support an immunological etiology for PE.
To investigate the differences in the expression of TLRs 2, 4, 5, and 6 and a group of inflammatory cytokines including IL-1, IL-6, TNF-α and IFN-γ in placentas from PE and healthy pregnant women in their third trimester of pregnancy.
This case-control study was performed on fifteen PE and fifteen age and gestational matched healthy pregnant women in the third trimester of pregnancy. Real time PCR (RT-PCR) technique was used to determine the expression of TLRs 2, 4, 5, and 6 in the maternal and fetal parts of the placenta. Moreover, the expressions of IL-1, IL-6, TNF-α and IFN-γ at RNA level in placental samples, peripheral, and cord blood were investigated.
The results of the present study indicated that the expressions of TLRs 4, 5 and 6 were significantly increased in both maternal part (p<0.001 and p<0.003 for TLRs 4, 6 and TLR 5, respectively) and fetal part (p<0.001), while TLR2 showed significant increase only in the fetal part of PE placentas (p<0.002). The levels of all studied cytokines showed over-expression within peripheral and cord blood samples from PE patients (p<0.001 for IL-1, IL-6, and IFN-γ and p<0.004 for TNF-α in both cord and peripheral blood samples).
The finding of the present study indicated that the expression of the studied TLRs and inflammatory cytokines are generally suppressed in normal pregnancy, but are up regulated in preeclamptic women. Moreover, it seems that the maternal and fetal parts of the placenta may play different roles in the induction of the inflammatory status within the placenta.
子痫前期（PE）是最复杂且危及生命的妊娠疾病之一，被认为是全球孕产妇和胎儿死亡的主要原因。尽管PE的确切病因尚不清楚，但有几条证据支持PE的免疫病因学。
研究子痫前期孕妇和健康孕妇孕晚期胎盘组织中Toll样受体（TLRs）2、4、5、6以及一组炎性细胞因子（包括白细胞介素-1（IL-1）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ））表达的差异。
本病例对照研究选取了15名单纯性子痫前期患者和15名年龄及孕周匹配的孕晚期健康孕妇。采用实时荧光定量聚合酶链反应（RT-PCR）技术检测胎盘母胎部分TLRs 2、4、5、6的表达。此外，还研究了胎盘组织样本、外周血和脐血中IL-1、IL-6、TNF-α和IFN-γ在RNA水平的表达。
本研究结果表明，TLRs 4、5和6在胎盘母胎部分的表达均显著增加（TLRs 4、6分别为p<0.001和p<0.003，TLR 5为p<0.001），而TLR2仅在子痫前期胎盘的胎儿部分显著增加（p<0.002）。所有研究的细胞因子水平在子痫前期患者的外周血和脐血样本中均呈过表达（IL-1、IL-6和IFN-γ为p<0.001，脐血和外周血样本中的TNF-α为p<0.004）。
本研究结果表明，所研究的TLRs和炎性细胞因子的表达在正常妊娠中通常受到抑制，但在子痫前期妇女中上调。此外，胎盘的母胎部分似乎在胎盘内炎症状态的诱导中可能发挥不同作用。
