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目的研究妊娠期肝内胆汁淤积症(ICP)患者胎盘人类白细胞抗原F(HLA-F)蛋白表达水平及与其发病的相关性。方法选取2014年1月-2015年12月在该院住院分娩的单胎妊娠孕妇90例,其中轻度ICP 24例、重度ICP 20例、正常孕妇46例。采用免疫组化技术检测ICP患者和正常孕妇胎盘中HLA-F蛋白的表达;采用RT-PCR技术检测患者胎盘中HLA-F基因mRNA的表达,采用Western Blot技术检测蛋白的表达。结果 HLA-F仅在胎盘蜕膜板绒毛外滋养层细胞上有表达,轻、重ICP患者和正常孕妇的HLA-F mRNA的相对表达量比较,差异无统计学意义(P>0.05);轻度ICP患者与正常孕妇的HLA-F蛋白相对表达量比较,差异无统计学意义(P>0.05);重度ICP患者的HLA-F蛋白相对表达量显著低于正常孕妇的表达量,差异有统计学意义(P<0.05);ICP患者总体的HLA-F蛋白相对表达量低于正常孕妇的HLA-F蛋白表达量,差异有统计学意义(P<0.05);应用地塞米松组ICP患者和未应用地塞米松组ICP患者的HLA-F蛋白相对表达量比较,差异无统计学意义(P>0.05)。结论表达于绒毛外滋养层细胞上的HLA-F蛋白关系着母体对胎盘组织的免疫耐受情况,HLA-F的异常低表达可能是ICP的发病原因之一。
Objective To study the expression of human leukocyte antigen (HLA-F) protein in placenta of patients with intrahepatic cholestasis of pregnancy (ICP) and its correlation with the pathogenesis. Methods Ninety pregnant women with singletons who were hospitalized in our hospital from January 2014 to December 2015 were selected, including 24 cases of mild ICP, 20 cases of severe ICP and 46 cases of normal pregnant women. Immunohistochemistry was used to detect the expression of HLA-F protein in the placenta of ICP patients and normal pregnant women. RT-PCR was used to detect the expression of HLA-F mRNA in the placenta. The protein expression was detected by Western Blot. Results The expression of HLA-F was only found on the trophoblastic cells in the placental decidualized villi. There was no significant difference in HLA-F mRNA expression between light and heavy ICP patients and normal pregnant women (P> 0.05) There was no significant difference in the relative expression of HLA-F protein among ICP patients and normal pregnant women (P> 0.05). The relative expression of HLA-F protein in severe ICP patients was significantly lower than that in normal pregnant women (P <0.05). The relative expression of HLA-F protein in ICP patients was lower than that of normal pregnant women (P <0.05) There was no significant difference in the relative expression level of HLA-F protein in patients with dexamethasone without ICP (P> 0.05). Conclusion The expression of HLA-F protein on trophoblast cells is related to the immune tolerance of placenta. The abnormal expression of HLA-F may be one of the pathogenesis of ICP.