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正常妊娠和复杂妊娠中的体液免疫

Humoral immunity in normal and complicated pregnancy.

作者信息

Houwert-de Jong M H, Claas F H, Gmelig-Meyling F H, Kalsbeek G L, Valentijn R M, te Velde E R, Schuurman H J

出版信息

Eur J Obstet Gynecol Reprod Biol. 1985 Apr;19(4):205-14. doi: 10.1016/0028-2243(85)90031-0.

Abstract

To evaluate the role of some immunological phenomena involved in the pathogenesis of preeclamptic toxaemia, we studied the humoral immune reactivity in patients with preeclamptic toxaemia during the third trimester of pregnancy, and three days and six weeks after delivery. The results were compared with those of patients with intrauterine growth retardation and with uneventful pregnancy. During the third trimester, patients with complicated preeclamptic toxaemia had significantly lower IgG, CH50, C4 and C3 levels than normal pregnants. Post-partum levels of IgM were significantly higher than in all other groups of patients. Circulating immune complexes were not detectable by a C1q binding assay in patients and controls. However, with a conglutinin binding assay and a granulocyte phagocytosis test complexes were demonstrable in patients with complicated preeclampsia (incidence 44% and 33%, respectively). In addition, 66% of these patients showed deposits of immunoglobulins and complement components in superficial blood vessels of the skin biopsy, suggestive of the presence of tissue deposits of immune complexes. This was found in about 30% of the other patient groups and in none of control pregnants. Allo-antibodies to lymphocytes were present in 63% of complicated preeclamptic toxaemia patients and 22% of normal pregnants. Our data show several changes in humoral immune reactivity in preeclamptic toxaemia which may contribute to the pathogenesis of this disorder.

摘要

为了评估某些免疫现象在子痫前期毒血症发病机制中的作用,我们研究了子痫前期毒血症患者在妊娠晚期、分娩后三天和六周时的体液免疫反应性。将结果与宫内生长受限患者和正常妊娠患者的结果进行了比较。在妊娠晚期,患有复杂子痫前期毒血症的患者的IgG、CH50、C4和C3水平明显低于正常孕妇。产后IgM水平明显高于所有其他患者组。通过C1q结合试验在患者和对照组中均未检测到循环免疫复合物。然而,通过胶固素结合试验和粒细胞吞噬试验,在患有复杂子痫前期的患者中可证实有复合物(发生率分别为44%和33%)。此外,这些患者中有66%在皮肤活检的浅表血管中显示有免疫球蛋白和补体成分的沉积,提示存在免疫复合物的组织沉积。在其他患者组中约30%的患者中发现了这种情况,而正常妊娠孕妇中无一例出现。63%的患有复杂子痫前期毒血症的患者和22%的正常孕妇存在淋巴细胞同种抗体。我们的数据显示子痫前期毒血症患者的体液免疫反应性有几种变化,这可能有助于这种疾病的发病机制。

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