Marinoni E, De Pità O, Bresadola M, Ippoliti F, Di Iorio R
2nd Department of Obstetrics and Gynecology, La Sapienza University, Rome, Italy.
Gynecol Obstet Invest. 1994;38(4):236-40. doi: 10.1159/000292488.
Pregnancy is associated with modifications in the maternal immune system that may be involved in the absence of rejection of the fetoplacental graft characterized by the presence of paternal antigens. This active and specific tolerance towards the fetoplacental unit seems to be compromised in pregnancy-induced hypertension (PIH). To evaluate whether the immunological state in patients with PIH is altered with respect to normal pregnant women we studied 15 patients with PIH, 15 uncomplicated pregnant and 10 healthy nonpregnant women using monoclonal antibodies directed to specific lymphocyte antigen determinants, cytokines (TNF) and soluble molecules (sIL-2R, sCD8). The percentage of CD4 lymphocytes and of natural killer (NK) cells was significantly higher in PIH patients compared to controls (CD4: 42.9 +/- 10.5 vs. 32.7 +/- 12.5%; p < 0.05; NK: 14.7 +/- 6.3 vs. 8.3 +/- 3.4%; p < 0.01). However, these values did not differ when compared to normotensive nonpregnant controls (CD4: 53.1 +/- 5.9%; NK: 17.2 +/- 7.1%). In addition, the soluble IL-2 receptor (sIL-2R) was higher in PIH patients when compared to control patients (725.5 +/- 194.2 vs. 482.5 +/- 187.2 U/ml; p < 0.01). The immune response observed in normal pregnancies responsible for the tolerance towards the fetoplacental unit seems to be altered in PIH patients as suggested by higher levels of CD4 and NK cells, and sIL-2R. This may lead to a chronic rejection syndrome and be involved in the pathophysiology of PIH.
妊娠与母体免疫系统的改变有关，这种改变可能与在存在父系抗原的情况下不排斥胎儿 - 胎盘移植物有关。对胎儿 - 胎盘单位的这种主动和特异性耐受在妊娠高血压综合征（PIH）中似乎受到损害。为了评估PIH患者的免疫状态相对于正常孕妇是否发生改变，我们使用针对特定淋巴细胞抗原决定簇、细胞因子（TNF）和可溶性分子（sIL - 2R、sCD8）的单克隆抗体，研究了15例PIH患者、15例无并发症孕妇和10例健康非孕妇。与对照组相比，PIH患者中CD4淋巴细胞和自然杀伤（NK）细胞的百分比显著更高（CD4：42.9±10.5对32.7±12.5%；p<0.05；NK：14.7±6.3对8.3±3.4%；p<0.01）。然而，与血压正常的非孕妇对照组相比，这些值没有差异（CD4：53.1±5.9%；NK：17.2±7.1%）。此外，与对照患者相比，PIH患者中可溶性白细胞介素 - 2受体（sIL - 2R）更高（725.5±194.2对482.5±187.2 U/ml；p<0.01）。正如CD4、NK细胞和sIL - 2R水平升高所表明的，PIH患者中正常妊娠时观察到的对胎儿 - 胎盘单位耐受的免疫反应似乎发生了改变。这可能导致慢性排斥综合征，并参与PIH的病理生理学过程。
