自然杀伤细胞分类及与复发性流产的关系

doi:10.12280/gjszjk.20240588

摘要/Abstract

摘要：

复发性流产（recurrent spontaneous abortion，RSA）指与同一配偶在妊娠28周前连续2次或更多次出现妊娠丢失，其发病原因复杂，免疫因素中自然杀伤（natural killer，NK）细胞与RSA关系密切。NK细胞来源存在两种假设，可能源于子宫内膜造血祖细胞（hematopoietic progenitor cell，HPC），或由组织驻留NK（tissue-resident NK，trNK）细胞产生。根据表型和功能，NK细胞可分为多种亚群和亚型，不同类型功能各异。NK细胞在妊娠过程中发挥重要作用，如调控滋养细胞浸润、参与母胎免疫和促进胎儿生长等，但NK细胞功能异常可能导致妊娠失败。研究发现，RSA患者的蜕膜NK细胞活性、功能改变，极化过程紊乱，子宫NK细胞数量和细胞毒性变化都与RSA的发生密切相关。综述NK细胞的来源、分型、功能及与RSA的关系，为理解RSA发病机制及临床诊疗提供了理论依据。

关键词: 杀伤细胞, 天然, 流产, 习惯性, 妊娠, 免疫, 免疫耐受

Abstract:

Recurrent spontaneous abortion (RSA) refers to the occurrence of two or more consecutive pregnancy losses before 28 weeks of gestation with the same partner. The RSA pathogenesis is complex, including the immune factor. Previous studies have showed that natural killer (NK) cells are closely related to RSA. There are two hypotheses regarding the origin of NK cells. They may originate from hematopoietic progenitor cells (HPCs) in the endometrium, or produce by the tissue-resident NK (trNK) cells. According to the phenotype and function, NK cells can be divided into multiple subsets and subtypes, each with different functions. During pregnancy, NK cells play important roles, such as regulating trophoblast invasion, participating in materno-fetal immunity, and promoting fetal growth. However, the abnormal functions of NK cells may lead to pregnancy failure. In RSA patients, the overactivity and dysfunction of decidual NK cells, the disordered polarization process and the changed number and cytotoxicity of uterine NK cells, could be closely related to the occurrence of RSA. This article is focused on the origin, classification and functions of NK cells, as well as the relationship with RSA, in order to provide a theoretical basis for understanding the pathogenesis of RSA and clinical diagnosis and treatment.

Key words: Killer cells, natural, Abortion, habitual, Pregnancy, Immunity, Immune tolerance

季咏萱, 赵航, 张宁. 自然杀伤细胞分类及与复发性流产的关系[J]. 国际生殖健康/计划生育杂志, 2025, 44(3): 242-246.

JI Yong-xuan, ZHAO Hang, ZHANG Ning. Natural Killer Cells Classification and Relationship with Recurrent Spontaneous Abortion[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(3): 242-246.

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