国际生殖健康/计划生育 ›› 2022, Vol. 41 ›› Issue (6): 499-503.doi: 10.12280/gjszjk.20220255
收稿日期:
2022-05-18
出版日期:
2022-11-15
发布日期:
2022-11-18
通讯作者:
徐艳文
E-mail:xuyanwen@mail.sysu.edu.cn
基金资助:
LUO Wan-bin, XIONG Yu-jing, AI Xi-xiong, GU Fang, XU Yan-wen()
Received:
2022-05-18
Published:
2022-11-15
Online:
2022-11-18
Contact:
XU Yan-wen
E-mail:xuyanwen@mail.sysu.edu.cn
摘要:
慢性子宫内膜炎(chronic endometritis,CE)是一种以病原体感染为主要病因的子宫内膜慢性、持续性炎症,与不孕及辅助生殖助孕的不良妊娠结局密切相关。虽然目前应用抗生素治疗后CE患者的妊娠结局得到较大程度改善,但仍有部分持续性CE患者的病因未明、治疗效果不佳。越来越多的研究提示CE子宫内膜的免疫状态发生改变,并可能参与子宫内膜容受性降低和不良妊娠结局的病理过程。CE的免疫状态改变主要表现为以子宫自然杀伤细胞(uterine natural killer cell,uNK细胞)、巨噬细胞为代表的固有免疫细胞和以B细胞、CD4+T细胞为代表的适应性免疫细胞的数量改变,CD4+T细胞亚群比例失调,细胞因子和趋化因子表达异常。综述CE免疫状态改变的研究进展,以期从免疫角度加深对CE的病理特征和可能影响妊娠结局的内在机制的理解。
罗婉彬, 熊玉晶, 艾细雄, 古芳, 徐艳文. 慢性子宫内膜炎的内膜免疫状态[J]. 国际生殖健康/计划生育, 2022, 41(6): 499-503.
LUO Wan-bin, XIONG Yu-jing, AI Xi-xiong, GU Fang, XU Yan-wen. Endometrial Immune State of Chronic Endometritis[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(6): 499-503.
[1] |
Kitaya K, Takeuchi T, Mizuta S, et al. Endometritis: new time, new concepts[J]. Fertil Steril, 2018, 110(3):344-350. doi: 10.1016/j.fertnstert.2018.04.012.
doi: S0015-0282(18)30337-6 pmid: 29960704 |
[2] |
Cicinelli E, Matteo M, Tinelli R, et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy[J]. Hum Reprod, 2015, 30(2):323-330. doi: 10.1093/humrep/deu292.
doi: 10.1093/humrep/deu292 URL |
[3] |
Zeng S, Liu X, Liu D, et al. Research update for the immune microenvironment of chronic endometritis[J]. J Reprod Immunol, 2022, 152:103637. doi: 10.1016/j.jri.2022.103637.
doi: 10.1016/j.jri.2022.103637 URL |
[4] |
Shen M, O′Donnell E, Leon G, et al. The role of endometrial B cells in normal endometrium and benign female reproductive pathologies: a systematic review[J]. Hum Reprod Open, 2022, 2022(1): hoab043. doi: 10.1093/hropen/hoab043.
doi: 10.1093/hropen/hoab043 |
[5] |
Chen X, Mariee N, Jiang L, et al. Measurement of uterine natural killer cell percentage in the periimplantation endometrium from fertile women and women with recurrent reproductive failure: establishment of a reference range[J]. Am J Obstet Gynecol, 2017, 217(6):680.e1-680.e6. doi: 10.1016/j.ajog.2017.09.010.
doi: 10.1016/j.ajog.2017.09.010 |
[6] |
Disep B, Innes BA, Cochrane HR, et al. Immunohistochemical characterization of endometrial leucocytes in endometritis[J]. Histopathology, 2004, 45(6):625-632. doi: 10.1111/j.1365-2559.2004.02052.x.
doi: 10.1111/j.1365-2559.2004.02052.x pmid: 15569054 |
[7] |
Kitaya K, Yasuo T. Aberrant expression of selectin E, CXCL1, and CXCL13 in chronic endometritis[J]. Mod Pathol, 2010, 23(8):1136-1146. doi: 10.1038/modpathol.2010.98.
doi: 10.1038/modpathol.2010.98 URL |
[8] |
Ellinidi VN, Khromov-Borisov NN, Feoktistov AA, et al. CD20+B lymphocytes, a highly informative biomarker for early diagnosis of chronic endometritis[J]. Medical Immunology(Russia), 2019, 21(3):451-456. doi:10.15789/1563-0625-2019-3-451-456.
doi: 10.15789/1563-0625-2019-3-451-456 |
[9] |
Li Y, Yu S, Huang C, et al. Evaluation of peripheral and uterine immune status of chronic endometritis in patients with recurrent reproductive failure[J]. Fertil Steril, 2020, 113(1):187-196.e1. doi: 10.1016/j.fertnstert.2019.09.001.
doi: S0015-0282(19)32314-3 pmid: 31718829 |
[10] |
Matteo M, Cicinelli E, Greco P, et al. Abnormal pattern of lymphocyte subpopulations in the endometrium of infertile women with chronic endometritis[J]. Am J Reprod Immunol, 2009, 61(5):322-329. doi: 10.1111/j.1600-0897.2009.00698.x.
doi: 10.1111/j.1600-0897.2009.00698.x URL |
[11] |
Chen X, Liu Y, Zhao Y, et al. Association between chronic endometritis and uterine natural killer cell density in women with recurrent miscarriage: clinical implications[J]. J Obstet Gynaecol Res, 2020, 46(6):858-863. doi: 10.1111/jog.14250.
doi: 10.1111/jog.14250 URL |
[12] |
Seshadri S, Sunkara SK. Natural killer cells in female infertility and recurrent miscarriage: a systematic review and meta-analysis[J]. Hum Reprod Update, 2014, 20(3):429-438. doi: 10.1093/humupd/dmt056.
doi: 10.1093/humupd/dmt056 pmid: 24285824 |
[13] |
Kitazawa J, Kimura F, Nakamura A, et al. Alteration in endometrial helper T-cell subgroups in chronic endometritis[J]. Am J Reprod Immunol, 2021, 85(3):e13372. doi: 10.1111/aji.13372.
doi: 10.1111/aji.13372 |
[14] |
Chen P, Chen P, Guo Y, et al. Interaction Between Chronic Endometritis Caused Endometrial Microbiota Disorder and Endometrial Immune Environment Change in Recurrent Implantation Failure[J]. Front Immunol, 2021, 12:748447. doi: 10.3389/fimmu.2021.748447.
doi: 10.3389/fimmu.2021.748447 URL |
[15] |
Wang WJ, Zhang H, Chen ZQ, et al. Endometrial TGF-β, IL-10, IL-17 and autophagy are dysregulated in women with recurrent implantation failure with chronic endometritis[J]. Reprod Biol Endocrinol, 2019, 17(1):2. doi: 10.1186/s12958-018-0444-9.
doi: 10.1186/s12958-018-0444-9 URL |
[16] |
Wang W, Sung N, Gilman-Sachs A, et al. T Helper (Th) Cell Profiles in Pregnancy and Recurrent Pregnancy Losses: Th1/Th2/Th9/Th17/Th22/Tfh Cells[J]. Front Immunol, 2020, 11:2025. doi: 10.3389/fimmu.2020.02025.
doi: 10.3389/fimmu.2020.02025 pmid: 32973809 |
[17] |
Robertson SA, Care AS, Moldenhauer LM. Regulatory T cells in embryo implantation and the immune response to pregnancy[J]. J Clin Invest, 2018, 128(10):4224-4235. doi: 10.1172/JCI122182.
doi: 10.1172/JCI122182 URL |
[18] |
Puente E, Alonso L, Laganà AS, et al. Chronic Endometritis: Old Problem, Novel Insights and Future Challenges[J]. Int J Fertil Steril, 2020, 13(4):250-256. doi: 10.22074/ijfs.2020.5779.
doi: 10.22074/ijfs.2020.5779 pmid: 31710184 |
[19] |
Jensen AL, Collins J, Shipman EP, et al. A subset of human uterine endometrial macrophages is alternatively activated[J]. Am J Reprod Immunol, 2012, 68(5):374-386. doi: 10.1111/j.1600-0897.2012.01181.x.
doi: 10.1111/j.1600-0897.2012.01181.x URL |
[20] |
欧水英. CD38和CD138在合并慢性子宫内膜炎不孕症患者中的诊疗价值[J]. 深圳中西医结合杂志, 2021, 31(1):66-68. doi: 10.16458/j.cnki.1007-0893.2021.01.030.
doi: 10.16458/j.cnki.1007-0893.2021.01.030 |
[21] |
Cicinelli E, Haimovich S, De Ziegler D, et al. MUM-1 immunohistochemistry has high accuracy and reliability in the diagnosis of chronic endometritis: a multi-centre comparative study with CD-138 immunostaining[J]. J Assist Reprod Genet, 2022, 39(1):219-226. doi: 10.1007/s10815-021-02356-1.
doi: 10.1007/s10815-021-02356-1 URL |
[22] |
Piccinni MP, Raghupathy R, Saito S, et al. Cytokines, Hormones and Cellular Regulatory Mechanisms Favoring Successful Reproduction[J]. Front Immunol, 2021, 12:717808. doi: 10.3389/fimmu.2021.717808.
doi: 10.3389/fimmu.2021.717808 URL |
[23] |
Abdul Hussain G, Azizieh F, Makhseed M, et al. Effects of Progesterone, Dydrogesterone and Estrogen on the Production of Th1/Th2/Th17 Cytokines by Lymphocytes from Women with Recurrent Spontaneous Miscarriage[J]. J Reprod Immunol, 2020, 140:103132. doi: 10.1016/j.jri.2020.103132.
doi: 10.1016/j.jri.2020.103132 URL |
[24] |
Alecsandru D, Garcia Velasco JA. The excessive presence (percentage or number) of endometrial immune cells in patients with chronic endometritis cannot be associated with reduced endometrial receptivity or recurrent pregnancy failure[J]. Fertil Steril, 2020, 113(1):85-86. doi: 10.1016/j.fertnstert.2019.10.008.
doi: S0015-0282(19)32478-1 pmid: 32033734 |
[25] |
Di Pietro C, Cicinelli E, Guglielmino MR, et al. Altered transcriptional regulation of cytokines, growth factors, and apoptotic proteins in the endometrium of infertile women with chronic endometritis[J]. Am J Reprod Immunol, 2013, 69(5):509-517. doi: 10.1111/aji.12076.
doi: 10.1111/aji.12076 URL |
[26] |
Danusevich I, Lazareva L, Nemchenko U, et al. Endometrial Cytokines in Women with Reproductive Disorders[J]. Int J Biomed, 2021, 11(4):526-531. doi: 10.21103/Article11(4)_OA20.
doi: 10.21103/Article11(4)_OA20 URL |
[27] |
Pavlov O, Selutin A, Pavlova O, et al. Macrophages are a source of IL-17 in the human placenta[J]. Am J Reprod Immunol, 2018, 80(4):e13016. doi: 10.1111/aji.13016.
doi: 10.1111/aji.13016 URL |
[28] |
Moustafa S, Joseph DN, Taylor RN, et al. New models of lipopolysaccharide-induced implantation loss reveal insights into the inflammatory response[J]. Am J Reprod Immunol, 2019, 81(2):e13082. doi: 10.1111/aji.13082.
doi: 10.1111/aji.13082 URL |
[29] |
Kitaya K, Tada Y, Hayashi T, et al. Comprehensive endometrial immunoglobulin subclass analysis in infertile women suffering from repeated implantation failure with or without chronic endometritis[J]. Am J Reprod Immunol, 2014, 72(4):386-391. doi: 10.1111/aji.12277.
doi: 10.1111/aji.12277 URL |
[30] |
Saini V, Arora S, Yadav A, et al. Cytokines in recurrent pregnancy loss[J]. Clin Chim Acta, 2011, 412(9/10):702-708. doi: 10.1016/j.cca.2011.01.002.
doi: 10.1016/j.cca.2011.01.002 URL |
[31] |
Couper KN, Blount DG, Riley EM. IL-10: the master regulator of immunity to infection[J]. J Immunol, 2008, 180(9):5771-5777. doi: 10.4049/jimmunol.180.9.5771.
doi: 10.4049/jimmunol.180.9.5771 URL |
[32] |
Boomsma CM, Kavelaars A, Eijkemans MJ, et al. Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF[J]. Hum Reprod, 2009, 24(6):1427-1435. doi: 10.1093/humrep/dep011.
doi: 10.1093/humrep/dep011 URL |
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