Han Mu-Tian, Cheng Wei, Zhu Rui, Wu Hui-Hua, Ding Jie, Zhao Nan-Nan, Li Hong, Wang Fu-Xin
Center of Human Reproduction and Genetics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China.
Department of Immunology, Anhui medical university, Hefei, China.
Am J Reprod Immunol. 2023 Jun;89(6):e13633. doi: 10.1111/aji.13633. Epub 2022 Oct 26.
Endometriosis patients undergoing in vitro fertilization-embryo transfer (IVF-ET) treatment suffer from poor oocyte quality, a reduced likelihood of the fertilization rate, and low embryo quality. The dysregulation of immune cells and cytokine profiles in the follicular fluid (FF) may play an important role in the competence of the oocyte and the development of the embryo, but the mechanism remains largely unknown.
A total of 40 proved advanced staged endometriosis patients were enrolled in this study. The pregnancy results were followed until all the embryos collected by the first oocyte retrieval cycle were used up. The immune cells subtypes in FF and serum collected on the day of oocyte retrieval were detected by flow cytometry and 27 cytokines were determined using the Bio-Plex Pro Human Cytokine 27-Plex Immunoassay. The specific effect of cytokine on the gene expression of human granulosa cells was determined by RT-qPCR.
The fertilization rate and the cumulative live birth rate were significantly lower in the endometriosis group. The ratio of CD4 /CD8 T cells in FF was significantly lower, while the level of IP-10, RANTES and G-CSF were statistically higher in the endometriosis group. The level of IP-10 correlated with the IVF outcome. Moreover, treated by IP-10, the mRNA level of FSHR and CYP19A1 the human granulosa cells were downregulated in vitro.
These results suggest that alterations of the lymphocyte subsets and cytokines in women with advanced endometriosis may have an impact on the oocyte development and resulting in poorer IVF outcomes.
接受体外受精 - 胚胎移植(IVF - ET)治疗的子宫内膜异位症患者存在卵母细胞质量差、受精率降低以及胚胎质量低的问题。卵泡液(FF)中免疫细胞和细胞因子谱的失调可能在卵母细胞的能力和胚胎发育中起重要作用,但机制仍 largely 未知。
本研究共纳入 40 例经证实为晚期子宫内膜异位症患者。随访妊娠结果直至第一个取卵周期收集的所有胚胎用完。在取卵当天收集的 FF 和血清中的免疫细胞亚型通过流式细胞术检测,使用 Bio - Plex Pro 人细胞因子 27 种检测法测定 27 种细胞因子。通过 RT - qPCR 确定细胞因子对人颗粒细胞基因表达的具体影响。
子宫内膜异位症组的受精率和累积活产率显著较低。FF 中 CD4 / CD8 T 细胞的比例显著较低,而子宫内膜异位症组中 IP - 10、RANTES 和 G - CSF 的水平在统计学上较高。IP - 10 的水平与 IVF 结果相关。此外,用 IP - 10 处理后,体外人颗粒细胞中 FSHR 和 CYP19A1 的 mRNA 水平下调。
这些结果表明,晚期子宫内膜异位症女性淋巴细胞亚群和细胞因子的改变可能影响卵母细胞发育并导致较差的 IVF 结果。