1. 1. 中山大学附属第一医院妇产科,广东,广州,510080
2. 广东省计划生育科学技术研究所,广东,广州,510600
网络首发:2017-01-20,
纸质出版:2017
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杨娟, 韦成厚, 祝彩霞, 等. 卵巢子宫内膜异位囊肿患者免疫调节细胞Th17/Treg 失衡的 临床研究[J]. 中山大学学报(医学科学版), 2017,38(1).
YANG Juan, WEI Cheng-hou, ZHU Cai-xia, et al. A Clinical Study on Imbalance of Th17/Treg in Patients with Ovarian Endometriosis[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(1).
摘要:【目的】探讨卵巢子宫内膜异位囊肿患者体内是否存在Th17/Treg 失衡的现象。【方法】采用病例对照研究方 法,实验组为腹腔镜术后病理确诊的卵巢子宫内膜异位囊肿患者(40例),对照组为同期因单纯输卵管因素不孕行(宫)腹腔 镜联合诊治术患者(40例)。分别收集两组患者的外周血、腹腔液、在位及异位内膜组织。流式细胞术检测外周血中Th17 和Treg占CD4+T细胞比例;ELISA分别检测两组患者血清及腹腔液中Th17分泌的IL-17、IL-22和Treg分泌的IL-10、TGF-β 浓度;Q-PCR检测在位及异位内膜组织中Th17特异转录因子ROR-γt mRNA和Treg特异转录因子FoxP3 mRNA表达水平。 【结果】①卵巢子宫内膜异位囊肿患者外周血中Th17占CD4+T细胞比例为(5.53 ± 2.12)%,较对照组的(2.16 ± 0.78)%明显 升高;Treg占CD4+T细胞比例为(4.22 ± 1.04)%较对照组的(6.14 ± 1.52)%明显降低,外周循环中呈现Th17/Treg平衡失调现 象。②与对照组比较,卵巢子宫内膜异位囊肿患者外周血中Th17分泌IL-17、IL-22浓度明显升高,Treg分泌TGF-β、IL-10浓 度明显降低;与之相反,卵巢子宫内膜异位囊肿患者腹腔液中Th17分泌IL-17、IL-22浓度较对照组降低,Treg分泌TGF-β、 IL-10的浓度明显升高。③卵巢子宫内膜异位囊肿患者异位内膜Treg特异转录因子FoxP3 mRNA表达水平较两组在位内膜 均明显升高,Th17特异转录因子ROR-γt mRNA表达水平较两组在位内膜均明显降低。【结论】卵巢子宫内膜异位囊肿患者 体内存在免疫调节细胞Th17/Treg平衡失调现象,在子宫内膜异位症发生发展的过程中出现了免疫调节的紊乱,免疫因素与 内异症的发病有相关性。
Abstract:【Objective】To investigate the disturbance between Th17 and Treg cell balance in ovarian endometriosis patients. 【Methods】Case-control study comparing 40 women with histo-pathologically confirmed ovarian endometriosis and with 40 control infertility women without visible endometriosis foci,pelvic inflammations who were subjected to laparoscopic surgery during the same period. Peripheral blood,peritoneal fluid,ovarian ectopic endometrial tissue and eutopic endometrial tissue of ovarian endometriosis patients and controls were collected during surgery. T lymphocytes subpopulations in peripheral blood were analyzed by flow cytometry using specific monoclonal antibodies recognizing CD4+,CD25+ and CD127-markers and CD3+,CD8-and IL-17A+markers. Then, IL-17,IL-22,IL-10and TGF-β concentration in the serum and peritoneal fluid was determined using enzyme linked immunosorbent assay(ELISA). Also,Q-PCR was performed to verify Foxp3 mRNA and ROR-γt mRNA expression differences in eutopic and ectopic endometrial tissue.【Results】1.The percentage of CD4+CD25+CD127-Treg cells was significantly decreased in the peripheral blood ofwomen with ovarian endometriosis compared with control women. On the other hand,the proportion of CD3+CD8-IL-17A+ Th17 cells was significantly increased in the peripheral blood of women with endometriosis compared with control women. 2. Comparing with the controls,the concentration of IL-17 and IL-22 was significantly higher in the serum of women with ovarian endometriosis,and the levels of IL-10 and TGF-β were significantly lower in the serum of women with endometriosis. On the contrast,in the peritoneal fluid of women with ovarian endometriosis,the concentration of IL-17 and IL-22 were lower,and the concentration of IL-10 and TGF-β were significantly higher than the controls. 3.Foxp3 mRNA expression level was significantly elevated in ectopic endometrial tissue of patients with ovarian endometriosis compared with eutopic endometrial tissue,while the ROR- γ t mRNA expression level of ectopic endometrial tissue was significantly decreased than eutopic endometrial tissue.【Conclusion】The present study verifies the imbalance of Th17/Treg in peripheral blood,peritoneal fluid and endometrial tissue in ovarian endometriosis patients,which implies the immune dysregulation and the disturbance of immunity homeostasis in the establishment and progression of endometriosis.
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