国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (1): 15-20.doi: 10.12280/gjfckx.20230709

• 产科生理及产科疾病:综述 • 上一篇    下一篇

胎盘源性外泌体在妊娠期免疫调节中的作用

张永清, 陈丹青()   

  1. 310006,浙江大学医学院附属妇产科医院产科
  • 收稿日期:2023-09-11 出版日期:2024-02-15 发布日期:2024-02-19
  • 通讯作者: 陈丹青 E-mail:chendq@zju.edu.cn
  • 作者简介:审校者
  • 基金资助:
    国家重点研发计划(2021YFC2700700)

The Role of Placenta-Derived Exosomes in Immune Regulation during Pregnancy

ZHANG Yong-qing, CHEN Dan-qing()   

  1. Department of Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
  • Received:2023-09-11 Published:2024-02-15 Online:2024-02-19
  • Contact: CHEN Dan-qing E-mail:chendq@zju.edu.cn

摘要:

胎盘在维持母胎界面的免疫耐受中发挥着关键作用。近年研究表明,胎盘合体滋养细胞可以不断向母体血循环中释放胎盘源性外泌体(placenta-derived exosomes,Pd-Exos),这些Pd-Exos及其内容物除了参与胚胎发育、着床等妊娠过程,还参与了妊娠期间的免疫调节,如抑制自然杀伤细胞毒性、抑制T细胞的活化及促进巨噬细胞的分化和极化等。对这些机制的精细调节是成功完成妊娠和获得母儿健康结局的关键。任何免疫耐受的破坏都会导致不良妊娠结局,如子痫前期、妊娠期糖尿病和早产等。综述Pd-Exos在正常生理妊娠期间的免疫调节作用及在免疫失衡后的妊娠相关并发症中的作用。

关键词: 胎盘源性外泌体, 合体滋养细胞, 免疫耐受, 妊娠并发症, 妊娠结局

Abstract:

The placenta plays a critical role in maintaining immune tolerance at the maternal-fetal interface. Recent research has shown that syncytiotrophoblast cells of the placenta continuously release placenta-derived exosomes (Pd-Exos) into the maternal bloodstream. These Pd-Exos and their contents not only participate in pregnancy processes such as embryogenesis and implantation, but also contribute to immune regulation during pregnancy. They inhibit natural killer cell cytotoxicity, suppress T-cell activation, and promote the differentiation and polarization of macrophages during pregnancy. Precise regulation of the mechanisms is crucial for successful pregnancy and achieving favorable maternal and fetal health outcomes. Disruption of immune tolerance can lead to adverse pregnancy outcomes such as preeclampsia, gestational diabetes mellitus, and preterm birth. In this review, we summarized the immunomodulatory functions of Pd-Exos during normal physiological pregnancy and their involvement in pregnancy-related complications due to maternal-fetal immune dysregulation.

Key words: Placenta-derived exosomes, Syncytiotrophoblast, Immune tolerance, Pregnancy complications, Pregnancy outcome