PDF(Pubmed)
Abstract：
Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) and gestational hypertension (GH), are major causes of maternal and foetal morbidity and mortality. This review elucidates the role of regulatory T cells (Tregs) in the immunological aspects of HDP and explores their therapeutic potential. Tregs, which play a critical role in maintaining immune homeostasis, are crucial in pregnancy to prevent immune-mediated rejection of the foetus. The review highlights that Tregs contribute to immunological adaptation in normal pregnancy, ensuring foetal acceptance. In contrast, HDP is associated with Treg dysfunction, which is marked by decreased numbers and impaired regulatory capacity, leading to inadequate immune tolerance and abnormal placental development. This dysfunction is particularly evident in PE, in which Tregs fail to adequately modulate the maternal immune response against foetal antigens, contributing to the pathophysiology of the disorder. Therapeutic interventions aiming to modulate Treg activity represent a promising avenue for HDP management. Studies in animal models and limited clinical trials suggest that enhancing Treg functionality could mitigate HDP symptoms and improve pregnancy outcomes. However, given the multifactorial nature of HDP and the intricate regulatory mechanisms of Tregs, the review explores the complexities of translating in vitro and animal model findings into effective clinical therapies. In conclusion, while the precise role of Tregs in HDP is still being unravelled, their central role in immune regulation during pregnancy is indisputable. Further research is needed to fully understand the mechanisms by which Tregs contribute to HDP and to develop targeted therapies that can safely and effectively harness their regulatory potential for treating hypertensive diseases of pregnancy.
摘要：
妊娠期高血压疾病（HDP）包括先兆子痫（PE）和妊娠期高血压（GH），是孕产妇和胎儿发病和死亡的主要原因。这篇综述阐明了调节性T细胞（Tregs）在HDP免疫学方面的作用，并探讨了其治疗潜力。Tregs,在维持免疫稳态方面发挥着关键作用，在怀孕期间对防止胎儿免疫介导的排斥反应至关重要。该综述强调，Tregs有助于正常妊娠的免疫适应，确保胎儿接受。相比之下,HDP与Treg功能障碍有关,其特点是数量减少和监管能力受损，导致免疫耐受不足和胎盘发育异常。这种功能障碍在PE中尤为明显，其中Tregs无法充分调节针对胎儿抗原的母体免疫反应，有助于疾病的病理生理学。旨在调节Treg活性的治疗性干预代表了HDP管理的有希望的途径。在动物模型和有限的临床试验中的研究表明，增强Treg功能可以减轻HDP症状并改善妊娠结局。然而,考虑到HDP的多因素性质和Tregs复杂的调控机制，这篇综述探讨了将体外和动物模型研究结果转化为有效临床治疗的复杂性。总之,虽然Tregs在HDP中的确切作用仍在解开，它们在怀孕期间的免疫调节中的核心作用是无可争辩的。需要进一步的研究来充分了解Tregs对HDP的作用机制，并开发能够安全有效地利用其治疗妊娠高血压疾病的调节潜力的靶向疗法。
