背景:组织蛋白酶C(CatC)参与炎症-免疫系统,并且可以被组织蛋白酶D(CatD)降解。子痫前期(PE)与炎症-免疫的关系是目前研究的热点,但是研究仍然很少。目的探讨CatC和D在非妊娠妇女血清中的表达及意义。妊娠不同阶段的患者和PE患者,以及正常妊娠和PE患者的胎盘。
方法:选择60名年轻健康的非妊娠妇女:180名正常妊娠妇女,包括第一个60个,第二,第三个三个月,和100名体育女性,包括39名重度子痫前期妇女。采用酶联免疫吸附试验(ELISA)检测血清中CatC和D的含量,免疫组织化学(IHC)检测胎盘中CatC和D的表达水平。
结果:孕早期CatC的血清明显低于未妊娠组(P<0.001),CatD显著高于非妊娠组(P<0.01)。妊娠中期和妊娠晚期的CatC和D水平明显高于妊娠早期(P<0.05),但妊娠中期和妊娠中期的C和D没有显着差异。PE患者血清和胎盘中CatC水平明显高于妊娠晚期(P<0.001),且与PE严重程度呈正相关(P<0.001)。而PE患者血清和胎盘中CatD的水平明显低于妊娠晚期(P<0.001),并且与PE的严重程度呈负相关(P<0.001)。年龄,primigravida比例,PE组体重指数明显高于对照组(P<0.05),是PE的高危因素。
结论:CatC和D与维持正常妊娠有关。在先兆子痫患者中,CatC的显著升高和CatD水平的显著降低可能导致先兆子痫的发生和发展。
BACKGROUND: Cathepsin C (Cat C) is involved in the inflammatory-immune system and can be degraded by cathepsin D (Cat D). Preeclampsia (PE) and the inflammation-immunity relationship is currently a hot research topic, but there are still few studies. The aim was to investigate the expression and significance of Cat C and D in the serum of nonpregnant women, patients in various stages of pregnancy and patients with PE, and in the placenta of patients with normal pregnancy and PE.
METHODS: Sixty young healthy nonpregnant women were selected: 180 normal pregnant women, including 60 each in the first, second, and third trimesters, and 100 women with PE, including 39 women with severe preeclampsia. The levels of Cat C and D in serum were detected by enzyme-linked immunosorbent assay (ELISA), and the expression levels of Cat C and D in placentas were detected by immunohistochemistry (IHC).
RESULTS: The serum of Cat C in the first trimester was significantly lower than that in the nonpregnant group (P < 0.001), whereas Cat D was significantly higher than that in the nonpregnant group (P < 0.01). The levels of Cat C and D in the second trimester and third trimester were significantly higher than those in the first trimester (P < 0.05), but there was no significant difference in Cat C and D between the second trimester and third trimester. The levels of Cat C in the serum and placentas of patients with PE were significantly higher than those in the third trimester (P < 0.001) and positively correlated with the severity of PE (P < 0.001), whereas the levels of Cat D in the serum and placentas of patients with PE were significantly lower than those in the third trimester (P < 0.001) and negatively correlated with the severity of PE (P < 0.001). Age, primigravida proportion, and body mass index were significantly higher in the PE group than in the control group (P < 0.05), which were high-risk factors for PE.
CONCLUSIONS: Cat C and D are associated with the maintenance of normal pregnancy. In patients with preeclampsia, a significant increase in Cat C and a significant decrease in Cat D levels may lead to the occurrence and development of preeclampsia.