{"title":"不明原因复发性自然流产患者Th1-Th2平衡的评价：一项系统综述和荟萃分析","authors":"Reza Kargar, Zahra Yahoo, Hosein Rafiemanesh, Saeed Aslani, Atefeh Shamosi, Hamed Mohammadi","doi":"10.1111/aji.70125","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>Unexplained recurrent spontaneous abortion (URSA) poses a major challenge in reproductive medicine, with increasing evidence of maternal immune dysregulation. This systematic review and meta-analysis assessed differences in T helper (Th) 1 and Th2 cell frequencies and their ratio between women with URSA and healthy fertile controls.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A comprehensive search of PubMed, Scopus, and Web of Science (WoS), up to October 2024, included studies evaluating peripheral blood Th subsets by flow cytometry.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Meta-analyses were performed for Th1(IFN-γ), Th1(TNF-α), Th2(IL-4), Th2(IL-10), and Th1/Th2 ratios. Th1(IFN-γ) frequencies were significantly higher in URSA (mean difference [MD] = 2.31, 95% CI = 0.30–4.33, <i>p</i> = 0.02), while Th2(IL-4) levels were lower (MD = −0.51, 95% CI = −0.91 to −0.11, <i>p</i> = 0.01). No significant differences were observed for Th1(TNF-α) (SMD = 0.25, 95% CI = −0.06 to 0.55, <i>p</i> = 0.11) and Th2(IL-10) (SMD = −0.28, 95% CI = −0.62 to 0.05, <i>p</i> = 0.10). The Th1(IFN-γ)/Th2(IL-4) ratio was significantly elevated (MD = 5.37, 95% CI = 1.47–9.27, <i>p</i> = 0.007), reflecting a shift toward a Th1-dominant immune profile.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>These findings support the role of Th1/Th2 imbalance in URSA and suggest its potential value as a diagnostic or prognostic marker.</p>\n </section>\n </div>","PeriodicalId":7665,"journal":{"name":"American Journal of Reproductive Immunology","volume":"94 1","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Th1-Th2 Balance in Patients With Unexplained Recurrent Spontaneous Abortion: A Systematic Review and Meta-Analysis\",\"authors\":\"Reza Kargar, Zahra Yahoo, Hosein Rafiemanesh, Saeed Aslani, Atefeh Shamosi, Hamed Mohammadi\",\"doi\":\"10.1111/aji.70125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>Unexplained recurrent spontaneous abortion (URSA) poses a major challenge in reproductive medicine, with increasing evidence of maternal immune dysregulation. This systematic review and meta-analysis assessed differences in T helper (Th) 1 and Th2 cell frequencies and their ratio between women with URSA and healthy fertile controls.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A comprehensive search of PubMed, Scopus, and Web of Science (WoS), up to October 2024, included studies evaluating peripheral blood Th subsets by flow cytometry.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Meta-analyses were performed for Th1(IFN-γ), Th1(TNF-α), Th2(IL-4), Th2(IL-10), and Th1/Th2 ratios. Th1(IFN-γ) frequencies were significantly higher in URSA (mean difference [MD] = 2.31, 95% CI = 0.30–4.33, <i>p</i> = 0.02), while Th2(IL-4) levels were lower (MD = −0.51, 95% CI = −0.91 to −0.11, <i>p</i> = 0.01). No significant differences were observed for Th1(TNF-α) (SMD = 0.25, 95% CI = −0.06 to 0.55, <i>p</i> = 0.11) and Th2(IL-10) (SMD = −0.28, 95% CI = −0.62 to 0.05, <i>p</i> = 0.10). The Th1(IFN-γ)/Th2(IL-4) ratio was significantly elevated (MD = 5.37, 95% CI = 1.47–9.27, <i>p</i> = 0.007), reflecting a shift toward a Th1-dominant immune profile.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>These findings support the role of Th1/Th2 imbalance in URSA and suggest its potential value as a diagnostic or prognostic marker.</p>\\n </section>\\n </div>\",\"PeriodicalId\":7665,\"journal\":{\"name\":\"American Journal of Reproductive Immunology\",\"volume\":\"94 1\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Reproductive Immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/aji.70125\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Reproductive Immunology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/aji.70125","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的不明原因复发性自然流产（URSA）是生殖医学面临的重大挑战，越来越多的证据表明，母体免疫失调。本系统综述和荟萃分析评估了辅助性T细胞（Th） 1和Th2细胞频率及其在URSA女性和健康生育对照组之间的差异。方法综合检索截至2024年10月的PubMed、Scopus和Web of Science (WoS)，包括用流式细胞术评估外周血Th亚群的研究。结果对Th1（IFN-γ）、Th1（TNF-α）、Th2（IL-4）、Th2（IL-10）和Th1/Th2比值进行meta分析。URSA患者中Th1（IFN-γ）频率显著升高（平均差异[MD] = 2.31, 95% CI = 0.30 ~ 4.33, p = 0.02）， Th2（IL-4）水平显著降低（MD = - 0.51, 95% CI = - 0.91 ~ - 0.11, p = 0.01）。Th1(TNF-α) （SMD = 0.25, 95% CI = - 0.06 ~ 0.55, p = 0.11）和Th2(IL-10) （SMD = - 0.28, 95% CI = - 0.62 ~ 0.05, p = 0.10）无显著差异。Th1(IFN-γ)/Th2（IL-4）比值显著升高（MD = 5.37, 95% CI = 1.47-9.27, p = 0.007），反映了向Th1显性免疫谱的转变。结论这些发现支持Th1/Th2失衡在URSA中的作用，并提示其作为诊断或预后指标的潜在价值。
Evaluation of Th1-Th2 Balance in Patients With Unexplained Recurrent Spontaneous Abortion: A Systematic Review and Meta-Analysis
Objective
Unexplained recurrent spontaneous abortion (URSA) poses a major challenge in reproductive medicine, with increasing evidence of maternal immune dysregulation. This systematic review and meta-analysis assessed differences in T helper (Th) 1 and Th2 cell frequencies and their ratio between women with URSA and healthy fertile controls.
Methods
A comprehensive search of PubMed, Scopus, and Web of Science (WoS), up to October 2024, included studies evaluating peripheral blood Th subsets by flow cytometry.
Results
Meta-analyses were performed for Th1(IFN-γ), Th1(TNF-α), Th2(IL-4), Th2(IL-10), and Th1/Th2 ratios. Th1(IFN-γ) frequencies were significantly higher in URSA (mean difference [MD] = 2.31, 95% CI = 0.30–4.33, p = 0.02), while Th2(IL-4) levels were lower (MD = −0.51, 95% CI = −0.91 to −0.11, p = 0.01). No significant differences were observed for Th1(TNF-α) (SMD = 0.25, 95% CI = −0.06 to 0.55, p = 0.11) and Th2(IL-10) (SMD = −0.28, 95% CI = −0.62 to 0.05, p = 0.10). The Th1(IFN-γ)/Th2(IL-4) ratio was significantly elevated (MD = 5.37, 95% CI = 1.47–9.27, p = 0.007), reflecting a shift toward a Th1-dominant immune profile.
Conclusions
These findings support the role of Th1/Th2 imbalance in URSA and suggest its potential value as a diagnostic or prognostic marker.
期刊介绍：
The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.
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