Chiokadze M, Kristesashvili J
The Centre for Reproductive Medicine "Universe", Tbilisi, Georgia.
Georgian Med News. 2019 Sep(294):31-36.
Disturbed endometrial factor, as a result of disbalance of immune cells, is regarded as one of the most controversial immunological pathways of RPL. Uterine NK (uNK) cells are major immune cells present in endometrium and key players in tolerogenic immune mechanisms during implantation/placentation in the first trimester of pregnancy. There is a growing interest worldwide in understanding the potential role of altered number and function of uNK cells towards the reproductive outcome. Intensive research is being carried out to find out reliable immune markers to predict the potential risk for subsequent miscarriage. Therefore, the measurement of uNK cells acquires more significance in research settings and in clinical investigational protocols as well. Furthermore, there is an increasing demand from couples with RPL for an "uNK cell count test" and "immune treatments". Methods of measurement of uNK cells during the last decades have been challenged with many factors, that have produced various types of investigational errors and differences in results between the research centres. Researchers emphasize an urgent need for an agreed standardized protocol for the measurement of uNK cells, in order to minimize variations between the results of different centres and translate NK cell research into clinical practice. The aim of this article is to highlight the methods of uNK cell measurement in women with RPL during the last decade, to analyse our own difficulties during the endometrial tissue sampling/processing, to describe a reliable methodology of uNK cell investigation by immunohistochemical approach and summarize current trends in this direction to the establishment of the standardized protocol.
由于免疫细胞失衡导致的子宫内膜紊乱因子,被认为是复发性流产(RPL)最具争议的免疫途径之一。子宫自然杀伤(uNK)细胞是子宫内膜中的主要免疫细胞,也是妊娠头三个月着床/胎盘形成期间耐受性免疫机制的关键参与者。全球范围内,人们越来越关注uNK细胞数量和功能改变对生殖结局的潜在作用。目前正在进行深入研究,以寻找可靠的免疫标志物来预测后续流产的潜在风险。因此,uNK细胞的检测在研究环境和临床研究方案中也变得更加重要。此外,患有RPL的夫妇对“uNK细胞计数检测”和“免疫治疗”的需求也在增加。在过去几十年中,uNK细胞的检测方法受到多种因素的挑战,这些因素导致了各种类型的研究误差以及研究中心之间结果的差异。研究人员强调迫切需要一个商定的uNK细胞检测标准化方案,以尽量减少不同中心结果之间的差异,并将NK细胞研究转化为临床实践。本文的目的是强调过去十年中RPL女性uNK细胞检测的方法,分析我们在子宫内膜组织采样/处理过程中遇到的困难,描述通过免疫组织化学方法进行uNK细胞研究的可靠方法,并总结这一方向上建立标准化方案的当前趋势。