卵巢早衰的免疫学病因及免疫干预研究进展

doi:10.6040/j.issn.1671-7554.0.2017.1280

摘要/Abstract

摘要： 卵巢早衰(POF)是指女性40岁之前出现卵巢功能衰退,是一种临床高度异质、病因混杂的妇科内分泌疾病,是导致女性不孕不育的重要原因之一。POF病因复杂,涉及染色体异常、基因突变、自身免疫异常、医源性损伤、代谢异常及感染等多种因素, 但大多数患者发病原因尚不明确。自身免疫异常在POF中占10%~30%,主要表现为存在抗卵巢自身抗体和免疫细胞介导的免疫性卵巢炎、伴发自身免疫性相关疾病,但目前自身免疫失调诱导卵泡耗竭的具体机制仍不明确,临床缺乏有效的免疫监测或诊断指标,相关免疫干预手段仍需循证医学以及高质量临床研究的证实。

关键词: 卵巢早衰, 自身免疫, 自身抗体, 免疫性卵巢炎, 治疗

Abstract: Premature ovarian failure(POF)is characterized by cessation of ovarian function in women younger than 40 years. It presents highly heterogeneous clinical phenotype and etiology, and greatly jeopardizes the fertility of patients. 山东大学学报 (医学版)56卷4期 -秦莹莹,等.卵巢早衰的免疫学病因及免疫干预研究进展 \=-Variable causes and pathogeneses have been identified, including chromosome abnormalities, genetic mutations, autoimmune dysfunctions, and iatrogenic, metabolic or infectious factors, whereas a large proportion of causes still remain unknown. Autoimmune dysfunctions are involved in the pathogenesis of 10%-30% of POF cases, evidenced by autoimmune oophoritis complicated with other autoimmune disorders. However, the contribution of autoimmune deregulation to the pathogenesis of ovarian follicles depletion and dysfunction remains elusive. Reliable diagnostic or predictive biomarkers for ovarian autoimmunity are still unavailable at present. The efficacy of immunological interventions needs evidence-based medicine and high quality clinical trials to confirm.

Key words: Premature ovarian failure, Autoimmunity, Autoantibody, Autoimmune oophoritis, Therapy

中图分类号:

R574

秦莹莹,张茜蒻. 卵巢早衰的免疫学病因及免疫干预研究进展[J]. 山东大学学报 (医学版), 2018, 56(4): 33-37.

QIN Yingying, ZHANG Xiruo. Research advances on the immunological pathogenesis and immunotherapy of premature ovarian failure[J]. Journal of Shandong University (Health Sciences), 2018, 56(4): 33-37.

参考文献

[1] 陈子江, 田秦杰, 乔杰, 等. 早发性卵巢功能不全的临床诊疗中国专家共识[J]. 中华妇产科杂志, 2017, 52(9): 577-581.
[2] 赵世刚, 陈子江. 重大生殖疾病的分子机制研究[J]. 生命科学, 2017, 29(1): 43-51. ZHAO Shigang, CHEN ZiJiang. Molecular mechanisms of major reproductive diseases[J]. Chinese Bulletin of Life Sciences, 2017, 29(1): 43-51.
[3] Haller-Kikkatalo K, Uibo R, Kurg A, et al. The prevalence and phenotypic characteristics of spontaneous premature ovarian failure: a general population registry-based study[J]. Hum Reprod, 2015, 30(5): 1229-1238.
[4] Qin Y, Jiao X, Simpson JL, et al. Genetics of primary ovarian insufficiency: new developments and opportunities[J]. Hum Reprod Update, 2015, 21(6): 787-808.
[5] 谢江燕, 赵俪梅, 东亚君, 等. 卵巢早衰的免疫学研究进展[J]. 实用妇产科杂志, 2013, 29(4): 259-262.
[6] Silva CA, Yamakami LY, Aikawa NE, et al. Autoimmune primary ovarian insufficiency[J]. Autoimmun Rev, 2014, 13(4-5): 427-430.
[7] La Marca A, Brozzetti A, Sighinolfi G, et al. Primary ovarian insufficiency, autoimmune causes[J]. Curr Opin Obstet Gynecol, 2010, 22(4): 277-282.
[8] Hoek A, Schoemaker J, Drexhage HA. Premature ovarian failure and ovarian autoimmunity[J]. Endocr Rev, 1997, 18(1): 107-134.
[9] Jacob S, Koc M. Autoimmune oophoritis: a rarely encountered ovarian lesion[J]. Indian J Pathol Microbiol, 2015, 58(2): 249-251.
[10] Ayesha, Jha V, Goswami D. Premature ovarian failure: an association with autoimmune diseases[J]. J Clin Diagn Res, 2016, 10(10): QC10-QC12.
[11] Reato G, Morlin L, Chen S, et al. Premature ovarian failure in patients with autoimmune Addisons disease: clinical, genetic, and immunological evaluation[J]. J Clin Endocrinol Metab, 2011, 96(8): E1255-1261.
[12] Dragojevic-Dikic S, Marisavljevic D, Mitrovic A, et al. An immunological insight into premature ovarian failure(POF)[J]. Autoimmun Rev, 2010, 9(11): 771-774.
[13] 付莉, 李守柔. 自身免疫性卵巢早衰[J]. 国外医学·妇幼保健分册, 2004, 15(4): 240-242. FU Li, LI Shourou. Autoimmune premature ovarian failure[J]. Foreign Medical Sciences Section of Maternal and Child Health, 2004, 15(4): 240-242.
[14] Turkington RW, Lebovitz HE. Extra-adrenal endocrine deficiencies in Addisons disease[J]. Am J Med, 1967, 43(4): 499-507.
[15] Gao J, Jiao X, Dang Y, et al. Identification of patients with primary ovarian insufficiency caused by autoimmunity[J]. Reprod Biomed Online, 2017, 35(4): 475-479.
[16] Petríková J1, Lazúrová I. Ovarian failure and polycystic ovary syndrome[J]. Autoimmun Rev, 2012, 11(6-7): 471-478.
[17] Khole V. Does ovarian autoimmunity play a role in the pathophysiology of premature ovarian insufficiency?[J]. J Mid life Health, 2010, 1(1): 9-13.
[18] Haller-Kikkatalo K, Salumets A, Uibo R. Review on autoimmune reactions in female infertility: antibodies to follicle stimulating hormone[J]. Clin Dev Immunol, 2012, 2012(1): 762541. doi: 10.1155/2012/762541
[19] 马小红, 徐仙. 卵巢早衰与自身免疫机制的研究进展[J]. 中国计划生育学杂志, 2007, 15(3): 186-188.
[20] 施晓波, 舒晴, 张晶. 卵巢早衰患者自身免疫反应性指标的检测及其意义[J]. 现代妇产科进展, 2007, 16(8): 591-593. SHI Xiaobo, SHU Qing, ZHANG Jing. Detection and anlysis of autoimmunity data on patients of premature ovarian failure[J]. Prog Obstet Gynecol, 2007, 16(8): 591-593.
[21] Košir Pogacnik R, Meden Vrtovec H, Vizjak A, et al. Possible role of autoimmunity in patients with premature ovarian insufficiency[J]. Int J Fertil Steril, 2014, 7(4): 281-290.
[22] Komorowska B. Autoimmune premature ovarian failure[J]. Prz Menopauzalny, 2016, 15(4): 210-214.
[23] Yldrm G, Tokmak A, Kokanal MK, et al. Association between some inflammatory markers and primary ovarian insufficiency[J]. Menopause, 2015, 22(9): 1000-1005.
[24] 谢江燕, 东亚君, 梁志清, 等. 卵巢早衰患者外周血CD4+CD25+Treg细胞的变化及意义[J]. 生殖与避孕, 2013, 33(4): 224-227.
[25] Jiao X, Zhang H, Ke H, et al. Premature ovarian insufficiency: phenotypic characterization within different etiologies[J]. J Clin Endocrinol Metab, 2017, 102(7): 2281-2290.
[26] 杨艳红, 姚元庆. 卵巢早衰的免疫学病因、病理及诊治[J]. 中国实用妇科与产科杂志, 2007, 23(12): 913-915.
[27] Cutolo M. Autoimmune polyendocrine syndromes[J]. Autoimmun Rev, 2014, 13(2): 85-89.
[28] Warren BD, Kinsey WK, McGinnis LK, et al. Ovarian autoimmune disease: clinical concepts and animal models[J]. Cell Mol Immunol, 2014, 11(6): 510-521.
[29] Lleo A, Moroni L, Caliari L, et al. Autoimmunity and Turners syndrome[J]. Autoimmun Rev, 2012, 11(6-7): A538-543.
[30] Persani L, Rossetti R, Cacciatore C, et al. Primary ovarian insufficiency: X chromosome defects and autoimmunity[J]. J Autoimmun, 2009, 33(1): 35-41.
[31] 王晓秋, 李大金. 卵巢功能早衰的免疫学发病机制及免疫治疗的研究进展[J]. 国际妇产科学杂志, 2016, 43(3): 245-249. WANG Xiaoqiu, LI Dajin. Research progress on the immunological pathogenesis and treatment of premature ovarian failure[J]. J Int Obstet Gynecol, 2016, 43(3): 245-249.
[32] Zhang J, Qiu X, Gui Y, et al. Dehydroepiandrosterone improves the ovarian reserve of women with diminished ovarian reserve and is a potential regulator of the immune response in the ovaries[J]. Biosci Trends, 2015, 9(6): 350-359.

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