uNK细胞在复发性流产中的作用研究进展

Research progress on the role of uNK cells in recurrent spontaneous abortion

  • 摘要: 据世界卫生组织的定义,复发性流产是指与同一配偶连续发生2 次及以上在妊娠28 周之前的妊娠丢失,约40% ~60%的复发性流产患者病因不明。在子宫内膜的增殖期,uNK细胞约占免疫细胞群总数的30% ~ 40%,在分泌期高达70%,在维持母胎界面的免疫微环境发挥着关键作用。本综述从诱导局部免疫耐受、促进子宫血管重构、调节滋养细胞分化与侵袭等方面描述了uNK细胞是如何参与正常生理妊娠中母胎界面的免疫平衡的维持,并从配受体结合异常、干扰子宫动脉重塑、激素调节轴异常等方面总结其功能异常在复发性流产中的作用途径,对进一步理解复发性流产发生机制、提供预防手段和治疗方法、改善疾病预后有重要的临床意义和广泛的应用前景。

     

    Abstract: According to the definition of the World Health Organization(WHO), recurrent spontaneous abortion refers to two or more successive pregnancy losses with the same spouse before 28 weeks of pregnancy. About 40%-60% of recurrent spontaneous abortion patients have unknown causes. During the proliferative phase of the endometrium, uterine natural killer cells account for approximately 30%-40% of the total immune cell population, and up to 70% during the secretory phase, playing a critical role in maintaining the immune microenvironment at the maternal fetal interface. This review describes how uterine natural killer cells participate in maintaining the immune balance at the maternal fetal interface during normal physiological pregnancy, including inducing local immune tolerance, promoting uterine vascular remodeling, and regulating trophoblast differentiation and invasion. It summarizes the functional pathways of uterine natural killer cells in recurrent miscarriage from aspects such as receptor binding abnormalities, interference with uterine artery remodeling, and hormone regulatory axis abnormalities. This has profound clinical implications and broad application prospects for further understanding the mechanism of recurrent miscarriage, providing prevention and treatment methods, and improving disease prognosis.

     

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