Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Immunol. 2022 Jun 10;13:877314. doi: 10.3389/fimmu.2022.877314. eCollection 2022.
The maternal-fetal immune disorder is considered to be an important factor of preterm birth (PTB); however, the underlying mechanism is still not fully understood. This study was designed to explore the innate and adaptive immune features in the decidua during term and preterm labor. Women delivered at term or preterm were classified into four groups: term not in labor (TNL, N=19), term in labor (TL, N=17), preterm not in labor (PNL, N=10), and preterm in labor (PIL, N=10). Decidua basalis and parietalis were collected and analyzed for macrophage subtypes (M1 and M2) as well as T helper 1 (Th1), Th2, Th17 and regulatory T (Treg) cells by flow cytometry and immunohistochemistry. Our results demonstrated significantly decreased frequencies of M2 cells and elevated M1/M2 ratio in the PIL group compared to that in the PNL group in both decidua basalis and parietalis, whereas no significant differences were found between the above two groups in both sites in terms of the polarization status of Th cells. On the contrary, macrophage subsets were comparable in the TL and TNL groups, whereas elevated Th1 percentages and Th1/Th2 ratio were observed in TL women compared to that in TNL women in the decidua. Interestingly, although the frequencies and ratios of Th17 and Treg were comparable among the four groups, the Th17/Treg ratios of these groups were significantly increased in decidua basalis than that in decidua parietalis. Collectively, the M1/M2 imbalance is associated with the breakdown of maternal-fetal immune tolerance during PTB, whereas the aberrant Th1/Th2 profile plays an important role in immune disorder during term labor. Moreover, Th17/Treg deviation is more remarkable in decidua basalis than in decidua parietalis.
母体-胎儿免疫紊乱被认为是早产（PTB）的重要因素；然而，其潜在机制仍不完全清楚。本研究旨在探讨足月和早产临产时蜕膜中的固有和适应性免疫特征。足月分娩或早产的妇女分为四组：足月未临产（TNL，N=19）、足月临产（TL，N=17）、早产未临产（PNL，N=10）和早产临产（PIL，N=10）。收集并分析蜕膜基底和壁蜕膜中的巨噬细胞亚型（M1 和 M2）以及 T 辅助 1（Th1）、Th2、Th17 和调节性 T（Treg）细胞，采用流式细胞术和免疫组织化学法。结果表明，与 PNL 组相比，PIL 组蜕膜基底和壁蜕膜中的 M2 细胞频率显著降低，M1/M2 比值升高，而两组在上述两个部位的 Th 细胞极化状态无显著差异。相反，TL 和 TNL 组的巨噬细胞亚群无差异，而与 TNL 组相比，TL 组妇女的 Th1 百分比和 Th1/Th2 比值升高。有趣的是，尽管四组 Th17 和 Treg 的频率和比值无差异，但这些组的 Th17/Treg 比值在蜕膜基底比在蜕膜壁蜕膜中显著升高。综上所述，M1/M2 失衡与 PTB 期间母体-胎儿免疫耐受的破坏有关，而异常的 Th1/Th2 谱在足月临产时的免疫紊乱中起重要作用。此外，Th17/Treg 的偏差在蜕膜基底比在蜕膜壁蜕膜中更为显著。
