胎盘来源外泌体在诊断胎儿生长受限中的应用

doi:10.12280/gjszjk.20220470

摘要/Abstract

摘要：

胎盘来源特异性外泌体是母胎界面细胞间通讯的重要媒介。妊娠期间胎盘释放大量外泌体，其内容物包括蛋白质、脂质和微小RNA（microRNA，miRNA）等，促进胚胎生长发育。miRNA作为外泌体生物活性物质，在疾病的早期诊断、临床治疗及预后中发挥重要作用，同时也参与胎儿生长受限（fetal growth restriction，FGR）的发生、发展。此外，外泌体来源的胎盘碱性磷酸酶（placental alkaline phosphatase，PLAP）、游离DNA（cell-free DNA，cfDNA）等也可作为特异性标志物应用于FGR的临床诊断。FGR是产科常见的并发症之一，是围产儿死亡的第二大原因，因此及早进行病因学诊断极为重要。介绍胎盘来源外泌体的功能，并综述其在FGR诊断中的应用进展。

关键词: 外泌体, 胎儿生长迟缓, 胎盘, 妊娠, 碱性磷酸酶, 微RNAs

Abstract:

The specific placenta-derived exosomes are important mediums for the communication between cells at the mother-to-fetus interface. During pregnancy, the placenta releases a large number of exosomes that promote the growth and development of embryos. These exosomes contain proteins, lipids, microRNAs, etc. As a kind of bioactive substances in exosomes, microRNAs participate in the occurrence and development of fetal growth restriction (FGR). Therefore, microRNAs may play an important role in the early diagnosis, clinical treatment and prognosis of diseases. In addition, the placental alkaline phosphatase (PLAP) and cell-free DNA (cfDNA) derived from exosome can also be used as specific markers in the clinical diagnosis of FGR. FGR is one of the common complications in obstetrics, which is the second leading cause of perinatal death. Therefore, early etiological diagnosis is extremely important. This article introduces the function of placenta-derived exosome and reviews its application in clinical diagnosis of FGR.

Key words: Exosomes, Fetal growth retardation, Placenta, Pregnancy, Alkaline phosphatase, MicroRNAs

李濛, 吴亚梅, 李佳雯, 郑小敏, 应豪, 黄璐. 胎盘来源外泌体在诊断胎儿生长受限中的应用[J]. 国际生殖健康/计划生育杂志, 2023, 42(2): 156-160.

LI Meng, WU Ya-mei, LI Jia-wen, ZHENG Xiao-min, YING Hao, HUANG Lu. Application of Placenta-Derived Exosomes in the Diagnosis of Fetal Growth Restriction[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(2): 156-160.

图/表 2

图1 外泌体的形成及在妊娠期的作用注：从早期核内体（early endosome）到晚期核内体（late endosome），再发育为内含蛋白质、脂质和RNA的外泌体（multivesicular body），外泌体在免疫反应（immune response）、物质交换（information transfer）及细胞黏附（cellular adhesion）中发挥重要作用。

图2 外泌体对胎儿和母体的作用[20] 注：外泌体有助于胎儿与母体的交流。外泌体在母体和胚胎组织之间进行物质交换，促进胚胎的着床（Implantation）、发育（Embryonic development）和延长分娩时间（Timing of birth）。通过抑制免疫反应（Immunosuppression）、改善代谢（Metabolic adaption）和血管反应性（Vascular reactivity），促进血管生成（Angiogenesis）和滋养细胞迁移、浸润（Migration/Invasion），使母体适应妊娠。外泌体也可能导致妊娠并发症，如子痫前期（pre-eclampsia，PE）、妊娠期糖尿病（gestational diabetes mellitus，GDM），并可能作为诊断FGR的生物标志物。

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