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目的:通过研究辅助性T细胞因子IL-4、IL-6及IFN-γ在子痫前期患者及血压正常的晚期妊娠妇女(NLP)胎盘母体面与胎儿面中的表达规律,探讨其在子痫前期发病过程中的病理生理机制。方法:选取子痫前期和正常妊娠孕妇作为研究组和对照组,应用免疫组化方法对两组胎盘的母体面与胎儿面Th1型细胞因子(IFN-γ)和Th2型细胞因子(IL-4、IL-6)进行标记并通过彩色病理图像分析系统对染色结果进行定量检测并作比较。结果:①胎盘母体面滋养细胞IFN-γ表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.2034±0.0148、0.2688±0.0278、0.2075±0.0154,子痫前期重度组与正常妊娠组差异有统计学意义(P<0.001);IL-6表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.1864±0.0009、0.1579±0.0070、0.1862±0.0127,子痫前期重度组与正常妊娠组差异有统计学意义(P<0.001);IL-4表达的平均光密度在子痫前期轻度组、重度组及正常妊娠组分别为0.2026±0.0163、0.1994±0.0163、0.2011±0.0124,3组比较差异均无统计学意义(P>0.05)。②胎盘胎儿面滋养细胞IFN-γ、IL-6、IL-4在子痫前期轻度组、重度组及正常妊娠组表达的平均光密度均无统计学差异。③子痫前期重度组滋养细胞IFN-γ、IL-6表达的平均光密度在胎盘母体面与胎儿面比较差异有统计学意义(P<0.05);IL-4表达的平均光密度在胎盘母体面与胎儿面比较,无统计学差异(P>0.05)。结论:在重度子痫前期孕妇胎盘母体面中表现为免疫杀伤的Th1型细胞因子表达增强,表现为免疫保护的Th2型细胞因子则表达减弱,而在胎盘胎儿面则无上述表现,提示胎盘母体面的Th1/Th2细胞因子失衡可能是导致子痫前期发病的病因之一。
Objective: To investigate the expression of helper T-cell factors IL-4, IL-6 and IFN-γ in placenta and fetal area of preeclampsia and normotensive late pregnant women (NLP) Pathophysiological mechanism during the pathogenesis of preeclampsia. Methods: Pregnant women with preeclampsia and normal pregnancy were selected as study group and control group. Immunohistochemistry was used to detect the expression of Th1-type cytokines (IFN-γ) and Th2 cytokines (IL-4 , IL-6) were labeled and the staining results were quantitatively detected and compared by a color pathological image analysis system. Results: ①The mean optical density of trophoblast IFN-γ in placenta was significantly lower in mild preeclampsia group than in severe preeclampsia group and normal pregnancy group (0.2034 ± 0.0148,0.2688 ± 0.0278,0.2075 ± 0.0154, P <0.05) The average optical density of IL-6 expression in mild pre-eclampsia group, severe group and normal pregnancy group were 0.1864 ± 0.0009,0.1579 ± 0.0070,0.1862 ± 0.0127, respectively, The average optical density of IL-4 expression in severe preeclampsia group was significantly lower than that in normal pregnancy group (0.2026 ± 0.0163,0.1994 ±), mild preeclampsia group and normal pregnancy group (P <0.001) 0.0163,0.2011 ± 0.0124, there was no significant difference between 3 groups (P> 0.05). ② There was no significant difference in the average optical density of IFN-γ, IL-6 and IL-4 in placental fetal trophoblast cells between mild and severe preeclampsia group and normal pregnancy group. ③ The average optical density of trophoblast IFN-γ and IL-6 in severe preeclampsia group was significantly different from that in fetal area (P <0.05). The average optical density of IL-4 expression in placenta There was no significant difference between facial and fetus (P> 0.05). Conclusions: Th1-type cytokines expressed in immunocompromised placenta in maternal serum of pregnant women with severe preeclampsia are enhanced, while the expression of immunoprotected Th2-type cytokines is weakened, but not in the placenta fetus, suggesting that placental precursors Surface imbalance of Th1 / Th2 cytokines may contribute to the pathogenesis of preeclampsia.