■探讨维生素D水平对不明原因复发性流产(URSA)患者外周血淋巴细胞亚群及血清Th1/Th2细胞因子的调节机制。
■选择2020年1月至2021年5月在四川金信新安妇女儿童医院就诊的80名URSA女性患者作为研究组,选择30名具有健康分娩史的年龄匹配妇女作为对照组,用流式细胞术检测不同维生素D水平人群的外周血淋巴细胞亚群和血清Th1/Th2细胞因子,分别。分析40例维生素D水平低的患者补充前后免疫因子的结果。对19例正常妊娠患者补充维生素D前后及正常妊娠后的淋巴亚群和Th1/Th2细胞因子的检测结果进行对比分析。
■(1)研究组血清25(OH)D低于对照组;外周血Th细胞,研究组B细胞和NK细胞高于对照组;IL-2、TNF-α、研究组IFN-γ和IL-6高于对照组,研究组IL-4、IL-10低于对照组(P<0.05)。(2)Th细胞,维生素D低水平组URSA患者的B细胞和NK细胞高于维生素D正常组;维生素D低水平组患者的血清细胞因子IL-2、TNF-α和IFN-γ高于维生素D正常组(P<0.05);(3)Th细胞,补充维生素D后URSA患者的B细胞和NK细胞均低于补充维生素D前;补充维生素D后血清细胞因子IL-2、TNF-α和IFN-γ均低于补充维生素D前,补充维生素D后IL-4和IL-10均高于补充维生素D前(P<0.05),补充维生素D前后IL-6无显著性差异。(4)Th细胞,正常妊娠患者补充维生素D后和妊娠后的B细胞和NK细胞均低于补充维生素D前;补充维生素D后和妊娠后的血清细胞因子IL-2、TNF-α和IFN-γ均低于补充维生素D前,补充维生素D后和妊娠后血清细胞因子IL-4和IL-10均高于补充维生素D前,TNF-α,妊娠后IFN-γ水平低于补充维生素D后(P<0.05),IL-6在补充维生素D前后和妊娠后没有显着差异。
■URSA患者维生素D缺乏率高。T、B、NK细胞与IL-2、TNF-α、IFN-γ,IL-6细胞因子高,而URSA患者的IL-6和IL-10水平较低。IL-2,TNF-α,IFN-γ细胞因子和Th,B,维生素D缺乏URSA患者的NK细胞增加,维生素D缺乏可能是URSA患者免疫功能紊乱的重要原因或加重因素。维生素D对URSA患者有免疫调节作用,通过下调外周血Th来促进成功怀孕,B,和NK细胞和IL-2,TNF-α,和IFN-γ细胞因子,同时上调IL-4和IL-10。
UNASSIGNED: To investigate the mechanism of vitamin D level on the regulation of peripheral blood lymphocyte subsets and serum Th1/Th2 cytokines in patients with unexplained recurrent spontaneous abortion (URSA).
UNASSIGNED: Eighty female patients with URSA attending Sichuan Jinxin Xinan Women\'s and Children\'s Hospital from January 2020 to May 2021 were selected as the study group, and 30 age-matched women with a history of healthy deliveries were chosen as the control group, and peripheral blood lymphocyte subpopulations and serum Th1/Th2 cytokines of people with different levels of vitamin D were detected in the study group by flow cytometry, respectively. The results of immune factors before and after supplementation were analyzed in 40 of these patients with low vitamin D levels. The results of lymphoid subpopulations and Th1/Th2 cytokines in 19 patients with normal pregnancy before and after vitamin D supplementation and after normal pregnancy were also analyzed comparatively.
UNASSIGNED: (1) Serum 25(OH)D in the study group was lower than in the control group; peripheral blood Th cells, B cells and NK cells in the study group were higher than in the control group; IL-2, TNF-α, IFN-γ and IL-6 in the study group were higher than in the control group, while IL-4 and IL-10 in the study group were lower than in the control group (P < 0.05). (2) Th cells, B cells and NK cells of URSA patients in the vitamin D low level group were higher than those in the vitamin D normal group; serum cytokines IL-2, TNF-α and IFN-γ of patients in the vitamin D low level group were higher than those in the vitamin D normal group (P < 0.05); (3) Th cells, B cells and NK cells in URSA patients after vitamin D supplementation were lower than before vitamin D supplementation; serum cytokines IL-2, TNF-α and IFN-γ after vitamin D supplementation were lower than before vitamin D supplementation, IL-4 and IL-10 after vitamin D supplementation were higher than before vitamin D supplementation (P < 0.05), and there was no significant difference in IL-6 before and after vitamin D supplementation. (4) Th cells, B cells and NK cells in patients with normal pregnancy after vitamin D supplementation and after pregnancy were lower than those before vitamin D supplementation; serum cytokines IL-2, TNF-α and IFN-γ after vitamin D supplementation and after pregnancy were lower than those before vitamin D supplementation, and serum cytokines IL-4 and IL-10 after vitamin D supplementation and after pregnancy were higher than those before vitamin D supplementation, TNF -α, IFN-γ after pregnancy were lower than after vitamin D supplementation (P < 0.05), IL-6 was not significantly different before and after vitamin D supplementation and after pregnancy.
UNASSIGNED: Vitamin D deficiency rate was high in URSA patients. Th、B、NK cells and IL-2, TNF-α, IFN-γ, IL-6 cytokines were high, while IL-6 and IL-10 were low in URSA patients. IL-2, TNF-α, IFN-γ cytokines and Th, B, NK cells were increased in vitamin D deficient URSA patients, and Vitamin D deficiency may be an important cause or aggravating factor of immune dysfunction in URSA patients. Vitamin D has an immunomodulatory effect on URSA patients, promoting successful pregnancy by down-regulating peripheral blood Th, B, and NK cells and IL-2, TNF-α, and IFN-γ cytokines, while up-regulating IL-4 and IL-10.