摘要

  目的

  了解反复种植失败(Repeated implantation failure,RIF)患者周围血树突状细胞(Dendritic cells,DC)数量和功能的变化。

  方法

  采集30例RIF患者及15例正常对照组的黄体中期周围血,采用流式细胞术(Flow cytometry,FCM)对其DC细胞功能分子及亚群进行检测。

  结果

  与正常对照组相比,RIF患者的lin-HLA-DR+DC细胞占白细胞的比例无显著性变化(P>0.05),DC细胞表面的共刺激分子(CD80和CD86)以及免疫耐受分子CD200也无显著性变化(P>0.05)。然而,RIF患者中CD11c+CD123-mDC细胞比例显著升高(P<0.05),而CD11c-CD123+pDC细胞比例无显著性变化(P>0.05)。

  结论

  RIF患者的周围血mDC细胞比例显著升高,其可能是影响RIF患者妊娠结局的因素之一。

  【关键词】母胎免疫耐受;反复种植失败;周围血;树突状细胞

  Analysis of quantity and function of dendritic cellsin peripheral blood of patients with repeated implantation failure

  【Abstract】

  Objective

  To evaluate thequantity and function changes of dendritic cells(DC)in peripheral blood ofpatients with repeated implantation failure(RIF).

  Methods

  30 patients withRIF and 15 normal controls were enrolled in this study,and the peripheral bloodwas collected during the mid-luteal phase.The percentage of DC subsets and theexpression levels of functional molecules were assessed by flow cytometric analysis.

  Results

  Compared withnormal controls,the percentage of lin-HLA-DR+DC cells accounting for leukocytesin patients with RIF was not significantly different(P>0.05).There were alsono significant differences in the expression levels of co-stimulatory molecules(CD80and CD86)and immune tolerant molecules CD200 on DC cells surfaces betweenpatients with RIF and normal controls(all P>0.05).In addition,the percentageof CD11c+CD123-mDC accounting for DC cells was significantly increased inpatients with RIF(P<0.05),however,the percentage of CD11c-CD123+pDC wassimilar(P>0.05).

  Conclusion

  The percentage ofmDC accounting for DC cells was significantly increased in patients withRIF,which may be one of factors affecting pregnancy outcomes.

  【Keywords】Maternal-fetal immunetolerance;Repeated implantation failure;Peripheral blood;Dendritic cells

  据世界卫生组织(WHO)评估,目前生殖障碍的发生率约为15%。随着体外受精-胚胎移植(In vitro fertilization-embryo transfer,IVF-ET)技术的发展,生殖障碍得到了明显的改善。但是,在IVF 治疗过程中,排除高龄、生殖系统畸形、遗传、内分泌等异常因素后仍有10% ~15%左右的患者经过多个周期治疗后仍然未能成功妊娠,通常这部分患者被定义为反复种植失败( Repeated implantation failure, RIF)。

  研究证明,胚胎的种植与母体免疫环境息息相关,机体的免疫细胞参与调控胚胎的种植过程。树突状细胞(Dendritic cell,DC)作为机体重要的抗原提呈细胞(Antigen presenting cell,APC),在正常妊娠中发挥重要作用。

  其中主要包括:

  (1)DC细胞通过低表达表面共刺激分子(CD80、CD86)和高表达表面耐受分子(CD200)诱导母体对胎儿的免疫耐受;

  (2)不同的DC细胞亚群,髓样DC细胞(myeloid DC,mDC)和浆细胞样DC 细胞(plasmacytoid DC,pDC),通过调节T细胞分化方向参与母胎免疫对话;并且,有文献报道,在小鼠的种植窗期去除DC细胞,其着床位点的形成受到抑制,进而导致胚胎着床失败。这些结果共同提示DC细胞的异常可能是影响RIF发生的重要因素。

  因此,本研究拟对RIF患者DC细胞的数量及其表面分子进行评估,进而为寻找新的母胎免疫致病因素,为寻找RIF患者治疗靶点提供理论依据。

  曾 勇 黄春宇 陈 现 梁佩燕

  刁梁辉 陈 聪 张 谞 尹 彪

  《中国免疫学杂志》2016年第32卷