摘要
不明原因复发性流产(URSA)占复发性流产患者比例的50%左右,其发病机制复杂。母胎界面免疫紊乱是URSA的重要致病因素,巨噬细胞是母胎界面蜕膜免疫细胞第二大细胞群,占蜕膜免疫细胞总量的20%~30%,是适应性免疫中关键的抗原提呈细胞,也是当前母胎免疫研究的热点。巨噬细胞在不同微环境下极化为促炎型M1巨噬细胞和抗炎型M2巨噬细胞,二者可随微环境的变化相互转化,这与中医阴阳学说之对立制约、消长平衡、互根互用、相互转化的思想在一定程度上相通相似。基于阴阳学说探讨巨噬细胞M1/M2平衡机制与URSA的相关性,汇总治疗URSA的重要信号通路/靶点,并对中药治疗URSA的靶点进行探讨,旨在为中医药治疗URSA提供科学依据。
Unexplained recurrent spontaneous abortion(URSA)accounts for approximately 50%of recurrent abortion cases,with a complex pathogenesis.Immune dysregulation at the maternal-fetal interface is a key pathogenic factor in URSA.Macrophages,which are the second largest immune cell population at the maternal-fetal interface,comprising 20%to 30%of the total decidual immune cells,are critical antigen-presenting cells in adaptive immunity and a focal point of current research on maternal-fetal immunity.Macrophages polarize into pro-inflammatory M1 macrophages and anti-inflammatory M2 macrophages under different microenvironments.The two can interconvert in response to changes in the microenvironment.This concept mirrors the yin-yang theory in traditional Chinese medicine(TCM)to some extent,which emphasizes the principles of opposition and restriction,dynamic balance of waxing and waning,mutual rooting and interdependence,and mutual transformation.Therefore,based on the yinyang theory,this paper explores the correlation between the mechanism of macrophage M1/M2 balance and URSA,summarizes the key signaling pathways and targets involved in the treatment of URSA,and investigates the potential targets of TCM for treating URSA.The aim is to provide scientific evidence for the application of TCM in the treatment of URSA.
作者
丁天送
谢京红
杨斌
关煜
李河桥
乔一倬
陈心如
田纹凡
李佳佩
张婉怡
李帆旋
DING Tiansong;XIE Jinghong;YANG Bin;GUAN Yu;LI Heqiao;QIAO Yizhuo;CHEN Xinru;TIAN Wenfan;LI Jiapei;ZHANG Wanyi;LI Fanxuan(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Beijing University of Chinese Medicine,Beijing 100029,China;Sujiatuo Township Community Health Service Center,Haidian District,Beijing 100194,China)
出处
《上海中医药杂志》
CSCD
2024年第12期28-34,共7页
Shanghai Journal of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程重大攻关项目(CI2021A02408)。
关键词
不明原因复发性流产
母胎免疫
巨噬细胞
阴阳学说
信号通路
靶点
中医药疗法
unexplained recurrent spontaneous abortion
maternal-fetal immunity
macrophages
yin-yang theory
signaling pathways
targets
traditional Chinese medicine therapy
