Lu Hongyan, Huang Yuhui, Xin Huang, Hao Cuifang, Cui Yanguo
a Qingdao University, Qingdao, Shandong, China.
b Reproductive Medicine Center of Zibo Maternal and Child Health Hospital , Zibo , Shandong , China.
Gynecol Endocrinol. 2018 Nov;34(11):933-939. doi: 10.1080/09513590.2018.1459546. Epub 2018 Jul 11.
The aim of this work was to study the expression of the cytokines IFN-γ, IL-4, IL-17 A, and TGF-β1 in peripheral blood and follicular fluid (FF) of patients positive for antithyroid autoantibodies (ATA) with normal thyroid gland function and the influence of these autoantibodies on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcomes. Nineteen patients were in the ATA group, and 27 patients tested negative for anti-thyroid autoantibody (ATA). Blood samples were drawn from the two groups of patients on the oocyte retrieval day and the 5th and 14th days of transplantation; in addition, FF was extracted on the oocyte retrieval day from both groups of patients and tested through enzyme-linked immunosorbent assay (ELISA) for IFN-γ, IL-4, IL-17 A, and TGF-β1. For the ATA group, the concentration of IFN-γ increased whereas the concentration of TGF-β1 decreased in peripheral blood on the oocyte retrieval day (p < .05); the concentration of IL-4 decreased in peripheral blood on the 5th and 14th days of transplantation for the ATA group (p < .05); further, the concentration of IL-17 A increased whereas that of TGF-β1 decreased in FF (p < .05). The ratio of IL-17 A/TGF-β1 in the ATA group significantly increased in FF and peripheral blood on the oocyte retrieval day and the 14th day of transplantation (p < .05). The ratio of IL-17 A/TGF-β1 in FF of the pregnant patients was significantly lower than in the non-pregnant patients (p < .05). The findings suggested that the ratio between pro-inflammatory and anti-inflammatory cytokines was adversely affected; therefore, adverse pregnancy outcomes of patients with ATA undergoing IVF-ET treatment may be attributed to immunological mechanisms.
本研究旨在探讨甲状腺功能正常的抗甲状腺自身抗体(ATA)阳性患者外周血和卵泡液(FF)中细胞因子IFN-γ、IL-4、IL-17 A和TGF-β1的表达情况,以及这些自身抗体对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。ATA组19例患者,27例抗甲状腺自身抗体(ATA)检测阴性患者作为对照组。两组患者均在取卵日、移植第5天和第14天采集血样;此外,两组患者均在取卵日抽取卵泡液,采用酶联免疫吸附测定(ELISA)检测IFN-γ、IL-4、IL-17 A和TGF-β1。ATA组在取卵日外周血中IFN-γ浓度升高而TGF-β1浓度降低(p<0.05);ATA组在移植第5天和第14天外周血中IL-4浓度降低(p<0.05);此外,卵泡液中IL-17 A浓度升高而TGF-β1浓度降低(p<0.05)。ATA组在取卵日和移植第14天卵泡液和外周血中IL-17 A/TGF-β1比值显著升高(p<0.05)。妊娠患者卵泡液中IL-17 A/TGF-β1比值显著低于未妊娠患者(p<0.05)。研究结果提示,促炎和抗炎细胞因子之间的平衡受到不利影响;因此,接受IVF-ET治疗的ATA阳性患者不良妊娠结局可能归因于免疫机制。