环孢素A治疗复发性流产的研究进展

doi:10.12280/gjszjk.20210233

摘要/Abstract

摘要：

复发性流产（recurrent spontaneous abortion,RSA）是常见的妇产科疾病,该病病因复杂,目前仍有部分RSA患者的病因尚不明确,可能与免疫因素异常密切相关。与免疫因素相关的治疗方案也引起了学者们的关注,其中细胞免疫抑制剂环孢素A（cyclosporine A,CsA）在RSA中的治疗作用逐渐被揭示。随着研究的深入,学者们发现CsA具有调节母胎免疫耐受和滋养细胞增殖、迁移、侵袭等作用,为其作为RSA相关用药提供了证据支持。从CsA调节母胎免疫耐受细胞因子的平衡、缓解滋养细胞免疫应激损伤、增强滋养细胞的增殖及侵袭力和减少滋养细胞凋亡等方面阐述CsA的胚胎保护机制,并结合最新有关CsA联合中药治疗RSA的临床报道,阐明CsA在RSA疾病中的治疗价值,为进一步研究CsA治疗RSA提供思路。

关键词: 环孢素A, 环孢菌素类, 免疫耐受, 滋养层, 流产,习惯性

Abstract:

Recurrent spontaneous abortion (RSA) is a common gynecological and obstetric disease. The etiology of RSA is complex, while the etiology of some RSA patients is still unclear, which may be closely related to abnormal immune factors. The therapeutic effect of cellular immunosuppressant cyclosporine A (CsA) in recurrent abortion has been gradually revealed. It has been found that CSA can regulate the maternal-fetal immune tolerance and trophoblast proliferation, migration and invasion, which provides evidence support for its use as a drug related to RSA. In this paper, we expound the embryonic protection mechanism of CsA from the various aspects. CsA participates in regulating the balance of maternal and fetal immune tolerance cytokines, alleviating the immune stress injury of trophoblast, enhancing the proliferation and invasion of trophoblast and reducing trophoblast apoptosis. Combined with the latest clinical reports on the CsA combined with traditional Chinese medicine in the treatment of RSA, we discuss the treatment application of CsA in RSA diseases, and provide ideas for further research on CsA in the treatment of RSA.

Key words: Cyclosporine A, Cyclosporins, Immune tolerance, Trophoblasts, Abortion, habitual

葛梦迪, 赵小萱, 赵颜, 冯晓玲. 环孢素A治疗复发性流产的研究进展[J]. 国际生殖健康/计划生育, 2021, 40(6): 514-518.

GE Meng-di, ZHAO Xiao-xuan, ZHAO Yan, FENG Xiao-ling. Research Progress of Cyclosporine A Treatment of Recurrent Spontaneous Abortion[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(6): 514-518.

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