Guo Zhaorong, Xu Yanting, Zheng Qiaoling, Liu Yunyun, Liu Xiaoyan
Department of Obstetrics and Gynecology, Weihai Central Hospital Affiliated to Qingdao University, Weihai, Shandong 264400, P.R. China.
Exp Ther Med. 2020 Apr;19(4):3159-3166. doi: 10.3892/etm.2020.8537. Epub 2020 Feb 21.
The present study investigated the genetic etiology and possible immunological pathogenesis of recurrent spontaneous abortion by analyzing chromosome abnormalities, and the balance between T helper 17 (Th17) and regulatory T (Treg) cells. A total of 54 patients with recurrent spontaneous abortion were selected. The villus and decidual tissues, and peripheral venous blood were collected from each patient. Villus chromosome analysis was performed by high-throughput gene sequencing. Flow cytometry was used to detect Th17 and Treg cells in patients without chromosome abnormalities (n=30) and the control group (normal pregnancy; n=32). Immunoglobulin (IG) combined with human chorionic gonadotropin hormone (HCG) treatment was given to patients without chromosome abnormalities (n=30). Changes in the expression levels of Th17 and Treg cells before and after treatment were compared with patients with successful pregnancy (n=18). Before treatment, compared with the control group, the proportion of Th17 cells in peripheral blood and decidual tissue was increased and the proportion of Treg cells decreased. After treatment, compared with patients before treatment, the proportion of Th17 cells decreased and Treg cells increased, and the Th17 and Treg cells balance was reversed with a biased towards Treg cells. The present results suggested that the Th17 and Treg cell immune imbalance may be an important immune factor in recurrent spontaneous abortion. IG combined with HCG therapy may improve pregnancy outcomes by reversing the imbalance between Th17 and Treg cells.
本研究通过分析染色体异常以及辅助性T细胞17(Th17)和调节性T(Treg)细胞之间的平衡,探讨复发性自然流产的遗传病因及可能的免疫发病机制。共选取54例复发性自然流产患者。采集每位患者的绒毛和蜕膜组织以及外周静脉血。采用高通量基因测序进行绒毛染色体分析。运用流式细胞术检测无染色体异常患者(n = 30)和对照组(正常妊娠;n = 32)中的Th17和Treg细胞。对无染色体异常患者(n = 30)给予免疫球蛋白(IG)联合人绒毛膜促性腺激素(HCG)治疗。将治疗前后Th17和Treg细胞表达水平的变化与成功妊娠患者(n = 18)进行比较。治疗前,与对照组相比,外周血和蜕膜组织中Th17细胞比例增加,Treg细胞比例降低。治疗后,与治疗前患者相比,Th17细胞比例降低,Treg细胞增加,Th17和Treg细胞平衡发生逆转,偏向Treg细胞。目前的结果表明,Th17和Treg细胞免疫失衡可能是复发性自然流产的一个重要免疫因素。IG联合HCG治疗可能通过逆转Th17和Treg细胞之间的失衡来改善妊娠结局。