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目的:探讨原因不明习惯性流产（UHA）患者主动免疫治疗前后外周血IL-4和 IL-12mRNA水平的变化。方法:用半定量逆转录-聚合酶链反应（RT-PCR）技术,检测30例正常非孕妇女和30例UHA妇女的外周血单个核细胞内IL-4和IL-12mRNA表达水平的相对含量（％）。结果:①UHA组妇女外周血单个核细胞上IL-4mRNA的相对含量,明显低于正常非孕组妇女（P<0.01）。而IL-12 mRNA的相对含量明显高于正常非孕组妇女（P<0.05）。②主动免疫治疗后,UHA组妇女外周血单个核细胞上IL-4 mRNA的相对含量较治疗前明显升高（P<0.05）,而IL-12mRNA的相对含量较治疗前明显降低（P<0.01）。③主动免疫治疗后,UHA组妇女上述细胞因子mRNA的相对含量与正常非孕组妇女相比无显著差异。④主动免疫治疗后,妊娠成功者其外周血单个核细胞上IL-4 mRNA的相对含量较治疗前明显升高（P<0.05）,IL-12 mRNA的相对含量较治疗前明显降低（P<0.05）;而妊娠失效者IL-4和IL-12 mRN的相对含量与治疗前无显著差异。结论:IL-4和IL-12的表达异常与UHA的发生密切相关,主动免疫治疗可上调IL-4的表达及下调IL-12的表达,可能进一步诱导TH2分化和抑制TH1分化,从而促使TH1/TH2型细胞因子平衡向TH2为主的模式转换,并使妊娠获得成功。
Objective: To investigate the changes of IL-4 and IL-12 mRNA in peripheral blood before and after active immunotherapy in patients with unexplained habitual abortion (UHA). Methods: The relative levels of IL-4 and IL-12 mRNA in peripheral blood mononuclear cells of 30 normal non-pregnant women and 30 UHA women were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) (%). Results: ① The relative content of IL-4 mRNA in peripheral blood mononuclear cells in UHA group was significantly lower than that in normal non-pregnant group (P <0.01). The relative content of IL-12 mRNA was significantly higher than the normal non-pregnant women (P <0.05). ② After active immunotherapy, the relative content of IL-4 mRNA in peripheral blood mononuclear cells in UHA group was significantly higher than that before treatment (P <0.05), while the relative content of IL-12 mRNA in UHA group was significantly lower than that before treatment (P <0.01) ). ③ active immunotherapy, UHA group of women, the relative content of cytokines mRNA in normal non-pregnant women compared to no significant difference. ④ After active immunotherapy, the relative content of IL-4 mRNA in peripheral blood mononuclear cells of pregnant women with pregnancy was significantly higher than that before treatment (P <0.05), and the relative content of IL-12 mRNA was significantly lower than that before treatment (P < 0.05). However, there was no significant difference in the relative content of IL-4 and IL-12 mRN between pregnancy failure and before treatment. CONCLUSIONS: The abnormal expression of IL-4 and IL-12 is closely related to the occurrence of UHA. Active immunotherapy can up-regulate the expression of IL-4 and down-regulate the expression of IL-12, which may further induce TH2 differentiation and inhibit the differentiation of TH1, / TH2-type cytokine balance to TH2-based mode conversion, and the success of pregnancy.