【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 m RNA和Treg特异转录因子Fox P3 m RNA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Fox P3 m RNA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 m RNA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。更多还原

【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-10 and 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 m RNA and ROR-γt m RNA 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 of women 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 m RNA expression level was significantly elevated in ectopic endometrial tissue of patients with ovarian endometriosis compared with eutopic endometrial tissue,while the ROR- γ t m RNA 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.更多还原