MIF和子痫前期炎症反应机制的关系

目的研究子痫前期胎盘组织炎症反应情况及巨噬细胞移动抑制因子（MIF）的表达,探讨MIF在子痫前期炎症反应中的作用。方法选取住院分娩的子痫前期孕产妇53例,其中轻度子痫前期孕产妇25例（轻度子痫前期组）,重度子痫前期孕产妇28例（重度子痫前期组）。另选取同期正常妊娠晚期孕产妇30例为对照组。采用逆转录（RT）PCR技术检测三组孕产妇胎盘组织中MIFmRNA的表达;采用免疫比浊法检测三组孕产妇血浆中CRP水平;采用ELISA方法检测三组孕产妇血浆中（TNF-α）、IL-6浓度。并对轻度及重度子痫前期组孕产妇血浆中CRP水平与胎盘组织中MIFmRNA表达的相关性进行分析。结果①三组孕产妇胎盘组织中均有MIF的表达,轻度子痫前期组孕产妇胎盘组织中MIFmRNA的水平为（0.84±0.13）,重度子痫前期组为（1.05±0.11）,两组比较,差异有统计学意义（P〈0.01）。对照组孕产妇胎盘组织中MIFmRNA为（0.70±0.12）,明显低于轻度及重度子痫前期组,差异均有统计学意义（P〈0.01）;②轻度子痫前期组孕产妇血浆CRP、（TNF-α）、IL-6浓度分别为（14.99±6.85）mg/L、（14.76±3.67）pg/ml、（24.68±10.13）pg/L,重度子痫前期组孕产妇血浆CRP、（TNF）、IL-6浓度分别为（21.16±8.89）mg/L、（19.66±6.13）pg/ml、（30.91±14.34）pg/L,差异有统计学意义（P〈0.01）;对照组孕产妇血浆CRP、（TNF）、IL-6浓度分别为（4.71±1.76）mg/L、（9.94±2.53）pg/ml、（14.14±5.06）pg/L,明显低于轻度及重度子痫前期组,差异有统计学意义（P〈0.01）;③轻度及重度子痫前期组孕产妇血浆中CRP水平与胎盘组织中MIFmRNA表达水平呈正相关（r=0.67,P〈0.01）。结论子痫前期患者胎盘组织中的MIF的过度表达,可上调血浆中炎性标志物CRP的水平,引起血管内皮损伤,从而参与子痫前期的发病。

Study of the correlation with macrophage migration inhibition factor and the inflammation in preeclampsia

Objective To investigate the role of macrophage migration inhibition factor(MIF) and inflammation in placenta of preeclampsia.Methods 53 women were recruited,including 25 women with mild preeclampsia(MPE group) and 28 women with severe preeclampsia(SPE group).Another 30 healthy pregnant women were taken as control group. Semiquantitative RT-PCR was applied to detect the expression of MIF mRNA;The concentrations of C-reactive protein(CRP) in plasma were tested by immunoturbidimetry and the concentration of tumor necrosis factor-alpha(TNF-α )and interleukin-6(IL-6) were measured by enzyme linked immunosorbent assay (ELISA). The relationship between the level of CRP in plasma and MIF mRNA in placenta was analyzed in the MPE and SPE groups.Results ① MIF were expressed in the placenta of all pregnant women in the 3 groups. The level of MIF mRNA in the MPE group(0.84±0.13) and SPE group(1.05±0.11) was significantly higher than that in control group(0.70±0.12)(P<0.01),and statistical significance was also found between the MPE and SPE group (P<0.01).② The plasma level of CRP,(TNF-α ) and IL-6 in MPE and SPE group were significantly higher than that in control group(14.99±6.85) mg/L,(14.76±3.67) pg/ml,(24.68±10.13) pg/L and (21.16±8.89) mg/L,(19.66±6.13) pg/ml,(30.91±14.34) pg/L vs (4.71±1.76) mg/L,(9.94±2.53) pg/ml,(14.14±5.06) pg/L (P<0.01)],and significant difference was also found between the MPE and SPE group(P<0.01).③ In the two preeclampsia groups, the plasma concentration of CRP was positively correlated- with the expression of MIFmRNA(r=0.67,P<0.01) in placenta.Conclusion Over expression of MIF in the placenta may up-regulate the CRP level in plasma, resulting in systermic inflammatory reaction and vascular endothelium damage which may be involved in the pathogenesis of preeclampsia.