不明原因复发性流产的免疫发病机制研究进展

doi:10.3969/j.issn.1674-8115.2021.10.016

摘要/Abstract

摘要：

复发性流产（recurrent spontaneous abortion，RSA）是妇产科最常见的妊娠并发症。RSA的病因复杂多样，除了已知的自身免疫异常、易栓症、内分泌因素、女性生殖道解剖异常、夫妻染色体异常、胚胎染色体或基因异常等因素外，仍然有40%~50%的患者流产原因不明，即为不明原因复发性流产（unexplained RSA，URSA）。由于病因及发病机制不明，临床治疗极其困难。近年来，随着生殖免疫学研究的不断进展，越来越多的研究证据提示URSA的发生和母胎免疫机制失衡有关，这为制定针对URSA的治疗策略带来了希望。该文就母胎界面和母胎免疫耐受的概念、母胎免疫耐受形成和失衡的机制，以及URSA的免疫发病机制的研究进展作一综述。

关键词: 不明原因复发性流产, 母胎界面, 母胎免疫耐受

Abstract:

Recurrent spontaneous abortion (RSA) is one of the most common pregnancy complications in gynecology and obstetrics. The etiology of RSA is complex and diverse. In addition to the known causes such as autoimmune abnormalities, thrombophilia, endocrine factors, anatomical abnormalities of female genital tract, chromosome abnormalities of husband and wife, and fetal chromosome or gene abnormalities, there are still 40%?50% of patients cannot find the exact cause, which is called unexplained recurrent spontaneous abortion (URSA). Due to the unknown etiology, it also brings great trouble to develop effective therapy. In recent years, with the development of reproductive immunology, more and more evidences suggest that the occurrence of URSA is related to the imbalance of maternal-fetal immune mechanisms, which also brings hope for the development of therapeutic strategies for URSA. This article reviews the concept of maternal-fetal interface and maternal-fetal immune tolerance, the mechanism of formation and imbalance of maternal-fetal immune tolerance, and the research progress of immune pathogenesis of URSA.

Key words: unexplained recurrent spontaneous abortion, maternal-fetal interface, maternal-fetal immune tolerance

中图分类号:

R714.21

柏文心, 赵爱民. 不明原因复发性流产的免疫发病机制研究进展[J]. 上海交通大学学报(医学版), 2021, 41(10): 1371-1377.

Wen-xin BAI, Ai-min ZHAO. Research progress in immune pathogenesis of unexplained recurrent spontaneous abortion[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(10): 1371-1377.

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