母胎界面免疫代谢微环境调节胚胎着床的研究进展

doi:10.12280/gjszjk.20230471

摘要/Abstract

摘要：

胚胎着床诱导母胎界面发生适应性的代谢重编程，形成低氧、低度炎症和弱酸性的微环境，这种微环境通过调节免疫细胞的募集、激活、代谢和极化，有助于子宫内膜容受态建立、蜕膜化、滋养细胞侵袭和母胎免疫耐受。胚胎成功着床需要免疫炎性反应和以糖酵解为主导的代谢重编程适时、适度的启动和结束。由病理因素介导的免疫代谢失调会导致胚胎着床失败或着床后流产等不良妊娠结局。巨噬细胞是种植窗口期子宫内膜数量最多的抗原提呈细胞，凭借极强的免疫可塑性和代谢灵活性，在母胎免疫代谢微环境的调节中发挥关键作用。综述母胎界面微环境中的免疫代谢调控机制，为制定临床干预策略以改善自然妊娠和辅助生殖助孕结局提供参考。

关键词: 胎盘, 母体胎儿间交换, 免疫活性, 能量代谢, 巨噬细胞, 胚胎植入

Abstract:

Embryo implantation induces the adaptive reprogramming of metabolism at the maternal-fetal interface, resulting in a hypoxic, mildly inflammatory, and slight acidic microenvironment. This type of microenvironment is conductive to establish endometrial receptivity, decidualization, trophoblast invasion and maternal-fetal immune tolerance by regulating the recruitment, activation, metabolism and polarization of immune cell. Successful embryo implantation necessitates the well-timed and suitable initiation and termination of the immune-inflammatory response and the glycolysis-dominated metabolic reprogramming. The dysregulation of immunometabolism caused by pathologic factors can result in adverse pregnancy outcomes, such as embryo implantation failure or post-implantation miscarriage. Macrophage as the most abundant antigen-presenting cell in the endometrium during the implantation window plays a crucial role in regulating immunometabolism at the maternal-fetal interface due to the remarkable immune plasticity and metabolic flexibility. We review the immunometabolic microenvironment and regulatory mechanisms at the maternal-fetal interface, to provide a reference for the advancement of clinical intervention approaches so as to improve the pregnancy outcomes in both natural conception and assisted reproduction.

Key words: Placenta, Maternal-fetal exchange, Immunocompetence, Energy metabolism, Macrophages, Embryo implantation

闻鑫, 赵晓丽, 栾祖乾, 夏天. 母胎界面免疫代谢微环境调节胚胎着床的研究进展[J]. 国际生殖健康/计划生育杂志, 2024, 43(2): 138-143.

WEN Xin, ZHAO Xiao-li, LUAN Zu-qian, XIA Tian. Immunometabolic Microenvironment at the Maternal-Fetal Interface Regulating Embryo Implantation[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(2): 138-143.

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