CAJ | 학술논문

目的通过分析母-胎界面T淋巴细胞受体(TCR)β链可变区(BV)基因的表达水平和频率,探索T淋巴细胞参与原因不明复发性流产(RSA)发生的作用机制.方法采集18例原因不明RSA患者(研究组)和4l例正常早孕人工流产妇女(对照组)的蜕膜组织,基因组扫描方法检测两组患者蜕膜内TCR BV基因的表达,分析TCR BV基因表达水平和频率的分布与原因不明RSA的关系.结果 (1)研究组患者蜕膜组织中TCR BV基因的表达水平,BV19为0.029±0.031,高于对照组(0.013±0.010),而BV5.2的表达水平(0.040±0.035)低于对照组(0.067±0.052),两组间分别比较,差异均有统计学意义(P<0.05).其余各家族的表达水平两组间比较,差异均无统计学意义(P>0.05).(2)研究组TCR BV家族中表达频率最高的前4位为BV2、BV6、BV7和BV3,其表达频率分别为66.7%、66.7%、66.7%和61.1%,均超过了50%.研究组中,BV15、BV19和BV20的表达频率分别为33.3%、38.9%和33.3%,均高于对照组(分别为7.3%、14.6%和7.3%);BV4和BV7的表达频率分别为33.3%和66.7%,均低于对照组(分别为65.9%和92.7%),两组间分别比较,差异均有统计学意义(P<0.05).其余各家族的表达频率两组间比较,差异均无统计学意义(P>0.05).结论原因不明RSA患者蜕膜组织内的TCR BV家族表达存在差异,表达频率变化显著的TCR BV家族可能导致免疫有关的流产发生的易感性.
목적 통과분석모-태계면T림파세포수체(TCR)β련가변구(BV)기인적표체수평화빈솔,탐색T림파세포삼여원인불명복발성유산(RSA)발생적작용궤제.방법 채집18례원인불명RSA환자(연구조)화4l례정상조잉인공유산부녀(대조조)적세막조직,기인조소묘방법 검측량조환자세막내TCR BV기인적표체,분석TCR BV기인표체수평화빈솔적분포여원인불명RSA적관계.결과 (1)연구조환자세막조직중TCR BV기인적표체수평,BV19위0.029±0.031,고우대조조(0.013±0.010),이BV5.2적표체수평(0.040±0.035)저우대조조(0.067±0.052),량조간분별비교,차이균유통계학의의(P<0.05).기여각가족적표체수평량조간비교,차이균무통계학의의(P>0.05).(2)연구조TCR BV가족중표체빈솔최고적전4위위BV2、BV6、BV7화BV3,기표체빈솔분별위66.7%、66.7%、66.7%화61.1%,균초과료50%.연구조중,BV15、BV19화BV20적표체빈솔분별위33.3%、38.9%화33.3%,균고우대조조(분별위7.3%、14.6%화7.3%);BV4화BV7적표체빈솔분별위33.3%화66.7%,균저우대조조(분별위65.9%화92.7%),량조간분별비교,차이균유통계학의의(P<0.05).기여각가족적표체빈솔량조간비교,차이균무통계학의의(P>0.05).결론 원인불명RSA환자세막조직내적TCR BV가족표체존재차이,표체빈솔변화현저적TCR BV가족가능도치면역유관적유산발생적역감성.
Objective To investigate T cell receptor(TCR)variable β(BV)chain usage at the maternal-fetal interface and explore the relationship between the skewed TCR BV usage and unexplained recurrent spontaneous abortion(BSA).Methods Eighteen cases with unexplained RSA,together with matched 41 women with normal pregnancies in first trimester from Renji Hospital,Shanghai Jiao Tong University were studied.A high-resolution spectrum typing analysis of complementarity-determining region 3 (CDR3)was used to detect and compare the degree and frequency of TCR BV family expression in deciduas between RSA patients and normal controls.Results(1)The expression degree of BV19(0.029±0.031 vs.0.013±0.010,P=0.038)in RSA group showed a higher usage,while BV5.2(0.040±0.035 vs.0.067±0.052,P=0.046)showed a significantly lower usage when compared with normal controls.No significant difference in the expression of the other TCR BV families between RSA and controls were observed(P>0.05).(2),TCR BV2,3,6,and 7 were the four most common BV families in deciduas of patients with RSA and normal controls,whose frequencies were all mors than 50%.In RSA group,higher frequencies of BV15 (33.3%vs.7.3%,P=0.018),BV19(38.9%vs.14.6%,P=0.049)and BV20(33.3%vs.7.3%,P=0.018)were observed;meanuhile lower frequencies of BV4(33.3%vs.65.9%,P=0.026)and BV7 (66.7%vs.92.7%.P=0.018)distributions were observed.The other TCR BV families did not display significantly different freqencies of distribution(P>0.05).Conclusions It is suggested that a significant skewed TCR BV family occurs at the maternal-fetal interface in patients who undergo abortion.The specific skewed usages of TCR BV might be associated with the susceptibility to unexplained pregnancy loss.