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母胎界面免疫微环境在分娩启动和早产发生中的作用和机制

袁建强¹, 王元辰¹, 王志明¹, 李励², 高路^1,*

¹海军军医大学基础医学院生理学教研室，上海 200433；²海军军医大学长海医院妇产科，上海 200433

摘要

人类妊娠维持和分娩启动，与母胎界面免疫微环境的动态平衡密切相关。妊娠早期，母胎界面丰富的血供和免疫细胞相互作用营造的免疫耐受微环境是胚胎着床的关键；临近分娩时，原位或招募的免疫细胞在母胎界面局部形成炎性反应环境，促使胎儿从母体排出。因此，母胎界面免疫微环境调控着妊娠和分娩的各个环节，其平衡紊乱或异常会导致流产或早产的发生。本文就母胎界面几种重要的免疫细胞在分娩启动及早产发生中的作用和机制加以综述。

关键词： 妊娠; 分娩; 母胎界面; 免疫微环境; 早产

分类号：R339.2

The immune microenvironment in maternal-fetal interface contributes to the parturition and preterm labor

YUAN Jian-Qiang¹, WANG Yuan-Chen¹, WANG Zhi-Ming¹, LI Li², GAO Lu^1,*

¹Department of Physiology, Naval Medical University, Shanghai 200433, China；²Department of Obstetrics and Gynecology, Changhai Hospital, Naval Medical University, Shanghai 200433, China

Abstract

The maintenance of human pregnancy and the initiation of parturition are closely related with the dynamic balance of the maternal-fetal immune microenvironment. Implantation of the blastocyst into the maternal decidua is the first step in pregnancy establishment, which is favored by the abundant blood flow and the immunotolerant microenvironment maintained by the balance of immune cells. The parturition resembles an inflammatory response that includes secretion of cytokines by resident and infiltrating immune cells into reproductive tissues and the maternal-fetal interface, which promotes the delivery of fetus from maternal organism. Therefore, the immune microenvironment in maternal-fetal interface regulates the critical steps of pregnancy and parturition. When the maternal-fetal immune microenvironment is imbalanced or impaired, miscarriage or preterm labor would happen. This article reviews the roles and mechanisms of several important immune cells in the maternal-fetal interface during the parturition and preterm labor.

Key words: Pregnancy; parturition; maternal-fetal interface; immune microenvironment; preterm labor

收稿日期：2019-07-24　　录用日期：2019-10-29

通讯作者：高路　　E-mail: roadgao@163.com

DOI: 10.13294/j.aps.2019.0084

引用本文：

袁建强, 王元辰, 王志明, 李励, 高路. 母胎界面免疫微环境在分娩启动和早产发生中的作用和机制[J]. 生理学报 2020; 72 (1): 1-10.

YUAN Jian-Qiang, WANG Yuan-Chen, WANG Zhi-Ming, LI Li, GAO Lu. The immune microenvironment in maternal-fetal interface contributes to the parturition and preterm labor. Acta Physiol Sin 2020; 72 (1): 1-10 (in Chinese with English abstract).