肝素治疗可下调抗磷脂抗体相关复发性流产女性血清颗粒溶素水平的上调。
Upregulated serum granulysin levels in women with antiphospholipid antibody-associated recurrent miscarriage are downregulated by heparin treatment.
作者信息
Ichikawa Tomoko, Negishi Yasuyuki, Kasano Sayuri, Yokote Ryoko, Yonezawa Mirei, Ouchi Nozomi, Kuwabara Yoshimitsu, Suzuki Shunji, Takeshita Toshiyuki
机构信息
Department of Obstetrics and Gynecology Nippon Medical School Tokyo Japan.
Department of Microbiology and Immunology Nippon Medical School Tokyo Japan.
出版信息
Reprod Med Biol. 2022 Apr 17;21(1):e12460. doi: 10.1002/rmb2.12460. eCollection 2022 Jan-Dec.
PURPOSE
Granulysin is a cytotoxic protein that simultaneously activates innate and cellular immunity. The authors aimed to evaluate whether granulysin is associated with the antiphospholipid antibody syndrome and whether heparin changes the granulysin levels.
METHODS
A cohort study was performed with women with antiphospholipid antibody-positive recurrent pregnancy loss (RPL). The authors examined granulysin levels under RPL and evaluated the changes in serum granulysin levels before and 1 week after the commencement of heparin treatment.
RESULTS
Serum granulysin levels before heparin treatment were significantly higher in women who tested positive for one or more types of antiphospholipid antibodies (2.75 ± 1.03 vs. 2.44 ± 0.69, = 0.0341 by Welch's test), particularly anti-phosphatidylethanolamine antibodies (IgG: 2.98 ± 1.09 vs. 2.51 ± 0.86, = 0.0013; IgM: 2.85 ± 1.09 vs. 2.47 ± 0.77, = 0.0024 by Welch's test). After heparin treatment for 1 week, serum granulysin levels were significantly reduced ( = 0.0017 by the paired test). The miscarriage rate was significantly higher in women whose serum granulysin levels were not reduced by heparin treatment ( = 0.0086 by Fisher's exact probability test).
CONCLUSION
The results suggest that heparin may reduce the incidence of miscarriage by suppressing serum granulysin levels.
目的
颗粒溶素是一种细胞毒性蛋白，可同时激活先天性免疫和细胞免疫。作者旨在评估颗粒溶素是否与抗磷脂抗体综合征相关，以及肝素是否会改变颗粒溶素水平。
方法
对患有抗磷脂抗体阳性复发性流产（RPL）的女性进行了一项队列研究。作者检测了RPL情况下的颗粒溶素水平，并评估了肝素治疗开始前和开始后1周血清颗粒溶素水平的变化。
结果
一种或多种抗磷脂抗体检测呈阳性的女性在肝素治疗前的血清颗粒溶素水平显著更高（2.75±1.03 vs. 2.44±0.69，通过韦尔奇检验，P = 0.0341），尤其是抗磷脂酰乙醇胺抗体（IgG：2.98±1.09 vs. 2.51±0.86，P = 0.0013；IgM：2.85±1.09 vs. 2.47±0.77，通过韦尔奇检验，P = 0.0024）。肝素治疗1周后，血清颗粒溶素水平显著降低（通过配对检验，P = 0.0017）。肝素治疗后血清颗粒溶素水平未降低的女性流产率显著更高（通过费舍尔精确概率检验，P = 0.0086）。
结论
结果表明，肝素可能通过抑制血清颗粒溶素水平来降低流产发生率。
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