Zhu Liqiong, Chen Hui, Liu Meilan, Yuan Yu, Wang Zhaohua, Chen Ying, Wei Jing, Su Fang, Zhang Jianping
1 Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.
2 Lin Bai-Xin Research Center of Medicine, Memorial Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou, China.
Reprod Sci. 2017 Jun;24(6):882-890. doi: 10.1177/1933719116670517. Epub 2016 Oct 2.
Regulatory T cells (Treg) and T helper 17 cells (Th17) are 2 distinct subsets of CD4 T cells, which are mutually antagonistic in the immune response. Recently, dysregulation of these 2 cell subsets have been described in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). The purpose of this study was to investigate whether the Treg/Th17 balance was perturbed in URSA patients and to explore contributing factors. We found that the proportion of Treg cells and expression of forkhead box P3 (Foxp3) messenger RNA (mRNA) were significantly lower in URSA patients than in healthy controls. However, the proportion of Th17 cells and expression of retinoid-related orphan nuclear receptor-γt (ROR-γt) mRNA were higher in URSA patients than in controls, revealing inverse correlation with Treg. The ratio of Treg/Th17 and Foxp3/ROR-γt decreased in patients with URSA compared to healthy controls. The serum levels of interleukin (IL)-6 and IL-17A were significantly higher, whereas IL-10 was lower in URSA patients compared with controls, and the level of IL-6 showed a positive correlation with Th17, ROR-γt and inverse correlation with Treg, Foxp3. The present study indicated that an imbalance between Treg and Th17 cells might be implicated in the pathogenesis of URSA and this seems to relate to elevation in serum IL-6 level.
调节性T细胞（Treg）和辅助性T细胞17（Th17）是CD4 T细胞的两个不同亚群，它们在免疫反应中相互拮抗。最近，在不明原因复发性自然流产（URSA）的发病机制中，已描述了这两个细胞亚群的失调。本研究的目的是调查URSA患者中Treg/Th17平衡是否受到干扰，并探讨相关因素。我们发现，URSA患者中Treg细胞的比例和叉头框P3（Foxp3）信使核糖核酸（mRNA）的表达明显低于健康对照。然而，URSA患者中Th17细胞的比例和维甲酸相关孤儿核受体γt（ROR-γt）mRNA的表达高于对照组，与Treg呈负相关。与健康对照相比，URSA患者中Treg/Th17和Foxp3/ROR-γt的比值降低。与对照组相比，URSA患者血清白细胞介素（IL）-6和IL-17A水平明显升高，而IL-10水平较低，且IL-6水平与Th17、ROR-γt呈正相关，与Treg、Foxp3呈负相关。本研究表明，Treg和Th17细胞之间的失衡可能与URSA的发病机制有关，这似乎与血清IL-6水平升高有关。
