Fas、FasL的表达与感染性早产胎盘滋养细胞凋亡的关系

目的　探讨胎盘Fas、FasL的表达及滋养细胞凋亡在感染性早产中的作用。方法　采用dUTP缺口末端标记法 (TUNEL)、免疫组化技术分别对四组 (感染性早产组 2 5例、早产无感染组 2 5例、足月感染组 3 1例及足月无感染组 3 1例 )胎盘组织 112例进行检测细胞凋亡和Fas、FasL基因的表达。结果　感染性早产组胎盘滋养细胞、羊膜上皮细胞、绒毛膜滋养细胞的凋亡指数较其它三组显著升高 (P <0 0 0 5 )。感染性早产组Fas阳性率最高 ,与其余三组比较有显著性差异 (P <0 0 0 5 ) ;感染性早产组FasL表达高于早产无感染组及足月无感染组 (P <0 0 0 5 )。感染性早产组 ,足月感染组胎盘、胎膜细胞凋亡指数 ,Fas、FasL表达均较其对应无感染组升高 ,但感染性早产组较早产无感染组FasL的升高幅度( 7 2 9% )显著低于Fas表达的升高幅度 ( 13 5 % ) (P <0 0 0 5 )。各组中胎盘胎膜细胞凋亡指数与Fas表达呈正相关 (P <0 0 0 1)。结论　在感染性早产中胎盘滋养细胞凋亡指数增加 ,同时Fas、FasL表达上调 ,可能Fas、FasL通过自分泌和旁分泌作用介导了胎盘滋养细胞的凋亡 ;但是FasL表达上调程度相对较低 ,可能导致母胎间免疫耐受失调 ,与感染性早产的发病有关。

Study on the expression of Fas,FasL and trophoblast apoptosis in placenta of infection associated preterm labor

Objective To study the role of Fas and FasL expression and trophoblast apoptosis in placenta of infection associated preterm labor.Methods 112 preterm or term delivery placenta samples were divided into 4 groups including infection associated preterm delivery (25 cases),preterm delivery without infection (25 cases),term delivery with infection (31 cases) and term delivery without infection (31 cases).Apoptosis index (AI) and the expression of Fas/FasL of all cases were detected by TUNEL (TdT-mediated dUTP nick end labeling) and immunohistochemistry,respectively.Results Apoptosis index (AI) of placental trophoblast,chorion trophoblast and amnion epithelial cell in infection associated preterm delivery was significantly higher than that of other three groups (P<0.005).The expression of Fas in infection-associated preterm delivery was the highest among 4 groups (P<0.005);The expression of FasL in infection associated preterm delivery was higher than that of preterm delivery without infection and term delivery without infection group (P<0.005).The expression of Fas/FasL and AI of placenta trophoblast cells in infection associated preterm labor and term delivery with infection was higer than that in preterm delivery without infection and term delivery without infection.Furthermore,the range of expression of FasL (7.29%) was lower than that of Fas (13.5%) in infection-associated preterm delivery (P<0.005).There was a highly significant and positive correlation between the expression of Fas and AI (P<0.001).Conclusion The AI was increased and Fas/FasL were upregulated in the infection-associated preterm delivery.Fas and FasL mediated the apoptosis of trophoblast cell through autocrine and paracrine.However,the expression of FasL reduced which compared with Fas and may result in uterus-placenta immunologic tolerance disturbance.These mechanisms may contribute to the pathogenesis of infection associated preterm labor.