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目的:从Th细胞特异性转录因子T-bet和GATA3的角度探讨其在子痫前期(pre-eclampsia)发病过程中可能的病理生理机制,为子痫前期的病因研究及免疫治疗提供思路。方法:采集正常产妇和子痫前期患者外周血单个核细胞(PB-MCs),提取总RNA,逆转录成cDNA,利用SYBRGreenI荧光定量PCR方法,以β-actin为内对照基因检测每组PBMCs中T-bet mRNA和GATA3 mRNA的表达水平。结果:①GATA3 mRNA在正常妊娠组、子痫前期轻度组和子痫前期重度组的表达随病情的加重表达减弱,子痫前期重度组与正常妊娠组相比差异有统计学意义(P<0.05),子痫前期轻度组与正常妊娠组、子痫前期重度组比较差异无统计学意义(P>0.05);②T-bet mRNA的表达随病情的加重表达增强,子痫前期重度组与正常妊娠组、子痫前期轻度组相比差异有统计学意义(P<0.05),子痫前期轻度组的表达也高于正常妊娠组,但差异无统计学意义(P>0.05);③T-bet mRNA/GATA3 mRNA比值结果显示,随病情的加重比值增大,且子痫前期重度组与正常妊娠组比较差异有统计学意义(P<0.05),子痫前期轻度组与正常妊娠组、子痫前期重度组相比差异无统计学意义(P>0.05)。结论:子痫前期患者外周血中表现为免疫杀伤的Thl型细胞转录因子T-bet mRNA表达增强,表现为免疫保护或免疫营养的Th2型细胞转录因子GATA3 mRNA表达减弱,提示子痫前期患者外周血中T-bet mRNA的高表达与其发病有关,GATA3 mRNA在子痫前期的发生、发展中的作用不如T-bet mRNA明显;T-bet mRNA/GATA3 mRNA比值随病情的加重而增大,提示外周血中Th1/Th2转录因子的平衡偏离可能是导致子痫前期发病的病因之一。
OBJECTIVE: To investigate the possible pathophysiological mechanism of Th-cell-specific transcription factors T-bet and GATA3 in the pathogenesis of pre-eclampsia, and provide ideas for the etiological study and immunotherapy of preeclampsia. Methods: Peripheral blood mononuclear cells (PBMCs) were collected from normal pregnant women and preeclampsia patients. The total RNA was extracted and reverse transcribed into cDNA. Using SYBR Green Ⅰ fluorescence quantitative PCR method and β-actin as internal control gene, -bet mRNA and GATA3 mRNA expression levels. Results: ① The expression of GATA3 mRNA in normal pregnancy group, mild preeclampsia group and severe preeclampsia group was weakened with the severity of the disease, and there was significant difference between severe preeclampsia group and normal pregnancy group (P <0.05) (P> 0.05). ② The expression of T-bet mRNA increased with the aggravating of the disease, and in severe preeclampsia group and normal pregnancy group, there was no significant difference between mild preeclampsia group and normal pregnancy group and severe preeclampsia group (P> 0.05) (P <0.05), mild preeclampsia group than normal pregnancy group, but the difference was not statistically significant (P> 0.05); ③T- bet mRNA / GATA3 mRNA ratio showed that with the aggravation of disease rate increased, and severe preeclampsia group compared with normal pregnancy group was statistically significant (P <0.05), preeclampsia mild group and normal pregnancy group, There was no significant difference in severe preeclampsia (P> 0.05). CONCLUSION: The expression of T-bet mRNA, a Th1 type cytokines, in peripheral blood of preeclampsia patients is enhanced. The expression of GATA3 mRNA, a Th2-type transcription factor, appears to be decreased by immuno-protection or immunization. The high expression of T-bet mRNA in blood correlated with its pathogenesis. The effect of GATA3 mRNA in the development of preeclampsia was not as obvious as that of T-bet mRNA. The ratio of T-bet mRNA / GATA3 mRNA increased with the progression of the disease The balance deviation of Th1 / Th2 transcription factors in peripheral blood may be one of the etiological factors leading to the pathogenesis of preeclampsia.