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观察妊娠高血压疾病(hypertensive disorders complicating pregnancy,PIH)患者外周血中血管内皮细胞因子的表达和树突状细胞的变化。实验组为妊娠高血压疾病患者86例,对照组为正常妊娠妇女20例,采集研究对象外周血,ELISA检测血清VEGF浓度;流式细胞术检测全血细胞中mDC、pDC水平;分离健康人PBMC,经贴壁获得单核细胞,加GMCSF,IL-4培养诱导为不成熟DC(immature dendritic cell,iDC),用LPS或不同浓度的VEGF干预iDC,流式细胞术检测表面分子标志CD14,CD83,HLA-DR的表达,混合淋巴细胞反应和流式细胞术检测经不同处理的DC刺激自体初始T淋巴细胞活化、分泌细胞因子的能力。VEGF在疾病组的含量低于正常妊娠组;pDC在子痫前期组的百分率低于正常妊娠组,疾病组mDC的百分率均高于正常妊娠组,在子痫前期、子痫患者组中的表达与正常妊娠组和妊娠高压组间的差异有统计学意义(P<0.05);子痫前期组和子痫组VEGF浓度与mDC的百分率之间呈负相关;经VEGF处理的三组DC表面CD80,CD83,CD86MFI均低于LPS组,高浓度VEGF干预的DC诱导Th0产生IFNγ/IL-4比值明显低于LPS处理组(P<0.05)。妊娠高血压疾病中VEGF和DC异常变化可能在疾病的免疫失衡中发挥作用。
To observe the changes of vascular endothelial cell factor and dendritic cells in peripheral blood of patients with hypertensive disorders complicating pregnancy (PIH). The experimental group was 86 cases of pregnancy-induced hypertension, the control group was 20 cases of normal pregnant women, the peripheral blood of the study subjects were collected, the concentration of serum VEGF was detected by ELISA, the levels of mDC and pDC in whole blood cells were detected by flow cytometry, Adherent monocytes, GMCSF and IL-4 were induced to immature dendritic cells (iDCs). The cells were treated with LPS or different concentration of VEGF for iDCs. Flow cytometry was used to detect the expression of CD14, CD83, The expression of HLA-DR, mixed lymphocyte reaction and flow cytometry were used to detect the ability of DCs stimulated autologous T lymphocyte activation and cytokine secretion by different treatment. The content of VEGF in the disease group was lower than that in the normal pregnancy group. The percentage of pDC in the preeclampsia group was lower than that in the normal pregnancy group. The percentage of mDC in the disease group was higher than that in the normal pregnancy group, and in the preeclampsia and eclampsia group (P <0.05). There was a negative correlation between VEGF concentration and the percentage of mDC in preeclampsia group and eclampsia group. The expressions of CD80, CD83 and CD86MFI in LPS group were lower than those in LPS group. The DC induced Th0 IFNγ / IL-4 ratio induced by high concentration of VEGF was significantly lower than that of LPS group (P <0.05). Abnormal changes in VEGF and DC in pregnancy-induced hypertension may play a role in the immune imbalance of the disease.