目的:观察可溶性 T细胞免疫球蛋白黏蛋白分子3(sTim-3)在原因不明性复发性流产(URSA)患者血清中表达水平的变化及其对 Th1/Th2细胞分化的调节,探讨 sTim-3在 URSA病理过程中的免疫机制。方法:选择52例URSA患者作为URSA组,选取同期正常妊娠孕妇20人作为正常妊娠组,育龄非孕者20人为健康对照组。采用 ELISA法检测3组研究对象血清 sTim-3和半乳糖结合蛋白9(Galectin-9)水平;双抗体夹心ELISA法检测血清中Th1型细胞因子干扰素γ(IFN-γ)和白细胞价素2(IL-2)、Th2型细胞因子 IL-4和 IL-10水平。结果:与健康对照组比较,URSA组患者血清 sTim-3(t=7.34,P<0.05)及 Galectin-9水平(t=4.86, P<0.05)均升高;URSA组患者血清 sTim-3水平明显高于正常妊娠组(t=5.63,P<0.05),而 Galectin-9水平则低于正常妊娠组(t=2.76,P<0.05)。正常妊娠组(t=2.81,P<0.05;t=2.84,P<0.05)和 URSA组(t=3.66,P<0.05;t=2.91,P<0.05)研究对象血清 IFN-γ及 IL-2水平低于健康对照组;URSA组患者血清IFN-γ和 IL-2水平明显高于正常妊娠组(t=6.11,P<0.05;t=5.95,P<0.05)。与健康对照组比较,正常妊娠组和 URSA组研究对象血清 IL-4和 IL-10水平升高(t=2.53,P<0.05;t=2.52,P<0.05;t=2.69,P<0.05;t=2.33,P<0.05);URSA组患者血清 IL-4和 IL-10水平明显低于正常妊娠组(t=6.48,P<0.05;t=7.76,P<0.05)。结论:sTim-3表达增加和Th1/Th2稳态调节失衡可能是导致 URSA患者反复流产的关键免疫机制之一。
Objective:To observe the changes of expression levels of serum soluble Tim-3 (sTim-3 )and its regulation effect on Th1/Th2 differentiaton in the patients with unexplained recurrent spontaneous abortion (URSA),and to investigate the possible immunmechanism of sTim-3 in the pathological process of URSA.Methods:A total of 52 patients with URSA were regarded as URSA group,and 20 normal pregnancy women at the same period were selected as normal pregnancy group and 20 non-pregnancy women in gestation age were selected as healthy control group.ELISA method was used to detect the levels of serum sTim-3 and galactose binding protein 9 (Galectin-9 )and the levels of serum Th1 cytokines interferonI-γ (IFN-γ)and IL-2 and Th2 cytokines IL-4 and IL-10 of the subjects in three groups.Results:Compared with healthy control group,the levels of serum sTim-3 (t=7.34,P<0.05)and Galectin-9 (t=4.86,P<0.05)of the patients in URSA group were increased. The level of serum sTim-3 of the patients in URSA group was significantly higher than that in normal control group (t=5.63,P<0.05),but the level of serum Galectin-9 of the pathents in URSA group was lower than that in normal control group (t=2.76,P<0.05).The levels of serum IFN-γand IL-2 of the subjects in normal control group (t=2.81,P<0.05;t=2.84,P<0.05)and URSA group (t=3.66,P<0.05;t=2.91, P<0.05)were lower than those in healthy control group.The levels of serum IFN-γand IL-2 of the patients in URSA group were higher than those in normal control group (t=6.11,P<0.05;t=5.95,P<0.05).The levels of serum IL-4 and IL-10 of all the subjects in normal pregnancy group and URSA group were higher than those in healthy control group (t=2.53,P<0.05;t=2.52,P<0.05;t=2.69,P<0.05;t=2.33,P<0.05);the IL-4 and IL-10 levels of the patients in URSA group were lower than those in normal control group (t=6.48,P<0.05;t=7.76,P<0.05).Conclusion:The increased expression of sTim-3 and the imbalance of Th1/Th2 homeostasis may be one of the key immunomechanisms of inducing recurrent abortion in the URSA patients.