不同产膜能力的念珠菌对妊娠期阴道炎患者Toll样受体通路及妊娠结局的影响

摘要/Abstract

摘要： 目的分析不同状态的念珠菌对妊娠期阴道炎患者外周血中Toll样受体信号通路的影响及与妊娠结局的关系。方法选取从妊娠期阴道炎患者中分离出的念珠菌，在体外构建生物膜模型，采用结晶紫和荧光染色法定性观察生物膜的生长及形态，并将其分为强产膜组、非产膜组。再选取178例健康产妇作为对照组。用RT-PCR法检测各组患者外周血单个核细胞中TLR2、TLR4、MyD88基因的表达量；采用ELISA测定各组细胞因子的浓度，同时统计分析各组产妇早产、羊水异常、胎膜早破等不良结局的情况。结果共分离178株念珠菌，其中强产膜64株，该组患者外周血TLR2、TLR4、MyD88基因表达量较对照组低，而非产膜组比对照组高（P<0.05）；血浆中IL-4在强产膜组中有明显升高（P<0.05），而非产膜组与对照组相比差异无统计学意义，而强产膜组患者血浆中IL-1β、TNF、IFN-γ浓度与对照组相比明显降低，非产膜组与对照组相比明显升高（P<0.05）；对照组不良妊娠结局发生率为2.8%，非产膜组不良妊娠结局为4.3%，强产膜组不良妊娠结局为21.8%，差异有统计学意义。结论强产膜念珠菌感染孕妇后通过下调TLR2、TLR4的表达导致机体的细胞免疫应答减弱，Th1/Th2比例失调，从而引起细胞因子表达量的变化，这可能是强产膜菌相对非产膜菌更容易发生免疫逃逸，引起机体慢性感染的原因之一，并且还可能增加不良妊娠结局的风险。

关键词: 妊娠期, 念珠菌, 生物膜, 妊娠结局

Abstract: Objective To analyze the effect of Candida in different states on Toll-like receptor signaling pathway in peripheral blood of patients with vaginitis during pregnancy and its relationship with pregnancy outcome. Methods Candida isolated from patients with vaginitis during pregnancy was selected to construct a biofilm model in vitro. Crystal violet and fluorescence staining were used to legally observe the growth and morphology of the biofilm to find strong membrane-producing group and non-film production group. Then 178 healthy parturients were selected as the control group. RT-PCR method was used to detect the expression of TLR2, TLR4 and MyD88 genes in peripheral blood mononuclear cells of each group of patients; ELISA was used to determine the concentration of cytokines in each group, and statistical analysis of maternal premature delivery, abnormal amniotic fluid and premature rupture of membranes And other bad endings. Results A total of 178 Candida strains were isolated, including 64 strains with strong membrane production. The peripheral blood TLR2, TLR4 and MyD88 gene expression of this group of patients was lower than that of the control group, while the non-film production group was higher than the control group (P<0.05). Compared with the control group, the plasma levels of IL-1β, TNF, and IFN-γ in the strong membrane-producing group were significantly lower than those in the control group (P<0.05). The incidence of adverse pregnancy outcomes in the control group in the non-membrane group and in the strong membrane group were 2.8%, 4.3%, and 21.8%. The difference was statistically significant. Conclusion Pregnant women infected with Candida of strong membrane-producing group could down-regulate the expression of TLR2 and TLR4, resulting in a weakened cellular immune response and an imbalanced Th1/Th2 ratio, which might cause changes in the expression of cytokines and could also increase the risk of adverse pregnancy outcomes.

Key words: pregnancy, candida, biofilm, pregnancy outcomes

中图分类号:

R519.3

李彩云, 柯婷婷, 李刚, 赵梅, 王文. 不同产膜能力的念珠菌对妊娠期阴道炎患者Toll样受体通路及妊娠结局的影响[J]. 中国真菌学杂志, 2021, 16(5): 330-334.

LI Caiyun, KE Tingting, LI Gang, ZHAO Mei, WANG Wen. Effects of Candida in different membrane production capacity on Toll-like receptor pathway and pregnancy outcome in patients with vaginitis during pregnancy[J]. Chinese Journal of Mycology, 2021, 16(5): 330-334.

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