母胎界面CD56bright自然杀伤细胞的免疫调节功能及其在妊娠中的作用
The Immunoregulatory Function of CD56bright Natural Killer Cells at the Maternal-Fetal Interface and Their Role in Pregnancy
摘要: 自然杀伤细胞在母胎界面处的独特表现与功能是成功建立和维持妊娠的关键。与外周血中以细胞毒性为主的Cd56dim Nk细胞亚型不同，孕期母胎界面中的Nk细胞主要为Cd56bright表型，这一群体具有低细胞毒性、高分泌性的特点，在母胎免疫耐受和胎盘形成中扮演着核心角色。本综述旨在系统阐述母胎界面Nk细胞，特别是Cd56bright亚群，在妊娠中的调节功能。首先，我们将重点分析Cd56bright Nk细胞通过分泌多种细胞因子介导的免疫调节与促进螺旋动脉重铸的功能，这是确保胎儿充足血供的基础。其次，我们将深入探讨母胎界面的特殊微环境如何精细调控Nk细胞的功能，其中，胎盘滋养细胞特异性表达的非经典Mhc-I分子Hla-G通过与Nk细胞表面的抑制性受体的相互作用，在建立局部免疫耐受中发挥至关重要的作用；同时，蜕膜基质细胞等通过分泌细胞因子共同构成了一个独特的免疫调节网络。此外，本综述还将讨论当这些调节机制失衡时，如何可能导致复发性流产、子痫前期等妊娠相关疾病的发生。最后，我们将展望该领域未来的研究方向，包括探索Nk细胞与其他免疫细胞的相互作用，以及基于Nk细胞功能调控的潜在治疗策略。通过整合最新文献，本文旨在为深入理解母胎免疫耐受的机制和妊娠疾病的病理生理提供全面的视角。
Abstract: Natural killer (NK) cells at the maternal-fetal interface exhibit unique phenotypic and functional features that are essential for the successful establishment and maintenance of pregnancy. In contrast to peripheral blood CD56dim NK cells, which are primarily cytotoxic, decidual NK cells during pregnancy are predominantly of the CD56bright phenotype. This subset is characterized by low cytotoxicity and a high secretory capacity, playing a central role in maternal-fetal immune tolerance and placental development. This review aims to systematically summarize the regulatory functions of maternal-fetal interface NK cells, with a particular focus on the CD56bright subpopulation. First, we highlight how CD56bright NK cells mediate immune regulation and promote spiral artery remodeling through the secretion of diverse cytokines, thereby ensuring adequate uteroplacental blood flow. Second, we explore the specialized microenvironment of the maternal-fetal interface that finely tunes NK cell function. In this context, the non-classical MHC-I molecule HLA-G, selectively expressed by trophoblasts, engages inhibitory receptors on NK cells and plays a pivotal role in establishing local immune tolerance. Decidual stromal cells further contribute to this regulatory network via cytokine secretion. Furthermore, we discuss how dysregulation of these mechanisms may contribute to pregnancy-related complications, including recurrent miscarriage and preeclampsia. Finally, we outline future research directions, such as elucidating the interactions between NK cells and other immune populations and developing therapeutic strategies targeting NK cell functionality. By integrating recent advances, this review provides a comprehensive perspective on the mechanisms underlying maternal-fetal immune tolerance and the pathophysiology of pregnancy disorders.
文章引用：蔡仓庆, 黄钧豪. 母胎界面CD56bright自然杀伤细胞的免疫调节功能及其在妊娠中的作用[J]. 临床医学进展, 2026, 16(7): 1633-1640. https://doi.org/10.12677/acm.2026.1672684

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