Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Egypt J Immunol. 2024 Jul;31(3):161-169.
Pregnancy results in an increase in immune cells, especially monocytes, which enhances the innate immune system. The increase of inflammatory cytokines in pregnant women's amniotic fluid, can cause uterine contraction, is linked to preterm labor. These inflammatory responses are controlled by Toll-like receptors (TLRs), which are largely expressed on neutrophils and monocytes. This study aimed to determine the role of neutrophils and monocyte subsets, as well as their expression of TLR-2 and TLR-4 in women with preterm and full-term delivery. The study involved a total of 74 women, comprising of 29 preterm labor, 25 full-term labor, and 20 non-pregnant women. The distribution of three monocyte subsets, namely (CD14++CD16-), (CD14+CD16+), and (CD14-/dim CD16++) was measured. Also, the expression of TLR2 and TLR4 in monocytes and neutrophils was analyzed using flow cytometry. Non-classical monocytes and intermediate monocytes were significantly higher in the preterm group than the control and full-term groups (p=0.041, p=0.043, and p=0.004, p= 0.049, respectively). Women in the preterm group showed significantly TLR2 expression on nonclassical monocytes compared to the control and full-term groups (p=0.002, and p=0.010, respectively). Also, preterm group expression of TLR4 was significantly higher in classical monocytes and nonclassical monocytes in comparison to the control group (p=0.019, and p≤0.0001, respectively). Besides, TLR4 expression was significantly up regulated in the preterm group compared to full-term in non-classical monocyte subset (p < 0.0001). Moreover, the expression of TLR-4 in neutrophils from the preterm group was statistically higher than expression from the full-term labor and control groups (p < .0001 for both). Such findings highlight the important role of monocyte subsets and neutrophils in activating the innate immune system and initiating strong pro-inflammatory responses that induce preterm labor. Additionally, TLR4 and TLR2 expressions on non-classical monocytes may be used as a marker to assess the probability of preterm labor.
妊娠会导致免疫细胞增加，尤其是单核细胞，从而增强先天免疫系统。孕妇羊水中炎症细胞因子的增加会导致子宫收缩，与早产有关。这些炎症反应受 Toll 样受体（TLR）的控制，TLR 主要在中性粒细胞和单核细胞上表达。本研究旨在确定中性粒细胞和单核细胞亚群及其 TLR-2 和 TLR-4 的表达在早产和足月分娩妇女中的作用。研究共纳入 74 名妇女，其中 29 名为早产，25 名为足月分娩，20 名为未怀孕妇女。测量了三种单核细胞亚群（CD14++CD16-）、（CD14+CD16+）和（CD14-/dim CD16++）的分布。还使用流式细胞术分析了单核细胞和中性粒细胞中 TLR2 和 TLR4 的表达。非经典单核细胞和中间单核细胞在早产组中的比例明显高于对照组和足月组（p=0.041，p=0.043，p=0.004，p=0.049）。与对照组和足月组相比，早产组非经典单核细胞上的 TLR2 表达明显更高（p=0.002，p=0.010）。此外，与对照组相比，经典单核细胞和非经典单核细胞中早产组的 TLR4 表达明显更高（p=0.019，p≤0.0001）。此外，与足月组相比，非经典单核细胞亚群中早产组的 TLR4 表达明显上调（p<0.0001）。此外，早产组中性粒细胞中 TLR-4 的表达明显高于足月分娩组和对照组（两者均 p<0.0001）。这些发现强调了单核细胞亚群和中性粒细胞在激活先天免疫系统和引发强烈促炎反应方面的重要作用，这些反应会导致早产。此外，非经典单核细胞上 TLR4 和 TLR2 的表达可以作为评估早产可能性的标志物。
